Provider Demographics
NPI:1659821619
Name:INTEGRATE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:INTEGRATE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:828-883-8262
Mailing Address - Street 1:41 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-3533
Mailing Address - Country:US
Mailing Address - Phone:828-883-8262
Mailing Address - Fax:828-883-8264
Practice Address - Street 1:19 CHESTNUT ST
Practice Address - Street 2:SUITE 3
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3055
Practice Address - Country:US
Practice Address - Phone:828-883-8262
Practice Address - Fax:828-883-8264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP7923261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy