Provider Demographics
NPI:1629397179
Name:MANUAL THERAPY OF ASHEVILLE, PA
Entity Type:Organization
Organization Name:MANUAL THERAPY OF ASHEVILLE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:828-257-2227
Mailing Address - Street 1:184 E CHESTNUT ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2377
Mailing Address - Country:US
Mailing Address - Phone:828-257-2227
Mailing Address - Fax:828-257-2227
Practice Address - Street 1:184 E CHESTNUT ST
Practice Address - Street 2:SUITE 7
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2377
Practice Address - Country:US
Practice Address - Phone:828-257-2227
Practice Address - Fax:828-257-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-24
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC201012300516-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty