Provider Demographics
NPI:1508948365
Name:WEST ASHEVILLE PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:WEST ASHEVILLE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MAUGER
Authorized Official - Last Name:BERNARDI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:828-258-2025
Mailing Address - Street 1:136 MIMOSA DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-1719
Mailing Address - Country:US
Mailing Address - Phone:828-258-2025
Mailing Address - Fax:828-258-2026
Practice Address - Street 1:136 MIMOSA DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-1719
Practice Address - Country:US
Practice Address - Phone:828-258-2025
Practice Address - Fax:828-258-2026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1508948365OtherCURRENT NPI