Provider Demographics
NPI:1689331985
Name:OUTSHINE PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC
Entity Type:Organization
Organization Name:OUTSHINE PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIEARA
Authorized Official - Middle Name:BISHOP
Authorized Official - Last Name:HINSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-808-3704
Mailing Address - Street 1:233 HUFF N PUFF LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-7078
Mailing Address - Country:US
Mailing Address - Phone:828-808-3704
Mailing Address - Fax:
Practice Address - Street 1:802 FAIRVIEW RD STE 950
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1171
Practice Address - Country:US
Practice Address - Phone:828-808-3704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-21
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy