Provider Demographics
NPI:1659527729
Name:OAK RIDGE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:OAK RIDGE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:D
Authorized Official - Last Name:MICHELS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:336-644-0201
Mailing Address - Street 1:PO BOX 875
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27310-0875
Mailing Address - Country:US
Mailing Address - Phone:336-644-0201
Mailing Address - Fax:336-644-0501
Practice Address - Street 1:2205 OAK RIDGE RD
Practice Address - Street 2:SUITE FF
Practice Address - City:OAK RIDGE
Practice Address - State:NC
Practice Address - Zip Code:27310-8728
Practice Address - Country:US
Practice Address - Phone:336-644-0201
Practice Address - Fax:336-644-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3679225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty