Provider Demographics
NPI:1689653594
Name:PHYSICAL THERAPY SPECIALISTS, LLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-322-7007
Mailing Address - Street 1:1344 N CENTER ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2796
Mailing Address - Country:US
Mailing Address - Phone:828-322-7007
Mailing Address - Fax:828-327-6006
Practice Address - Street 1:1344 N CENTER ST
Practice Address - Street 2:SUITE B
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-2796
Practice Address - Country:US
Practice Address - Phone:828-322-7007
Practice Address - Fax:828-327-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC015VHOtherBCBS
NC7533256OtherAETNA
NC7533256OtherAETNA