Provider Demographics
NPI:1700211554
Name:FAKHOURY PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:FAKHOURY PHYSICAL THERAPY, LLC
Other - Org Name:ANJALI HOT YATRA YOGA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:MS
Authorized Official - First Name:FERRIS
Authorized Official - Middle Name:ROWAN
Authorized Official - Last Name:FAKHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:864-915-6405
Mailing Address - Street 1:780 HENDERSONVILLE RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2900
Mailing Address - Country:US
Mailing Address - Phone:864-915-6405
Mailing Address - Fax:
Practice Address - Street 1:780 HENDERSONVILLE RD
Practice Address - Street 2:SUITE 14
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2900
Practice Address - Country:US
Practice Address - Phone:864-915-6405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5191261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy