Provider Demographics
NPI:1710924105
Name:METRO PHYSICAL THERAPY ASSOCIATES
Entity Type:Organization
Organization Name:METRO PHYSICAL THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAINE
Authorized Official - Middle Name:HYMAN
Authorized Official - Last Name:WINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:701-704-4976
Mailing Address - Street 1:9815 SAM FURR RD
Mailing Address - Street 2:SUITE J #81
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-4901
Mailing Address - Country:US
Mailing Address - Phone:704-701-4976
Mailing Address - Fax:704-895-9669
Practice Address - Street 1:15431 CROSSING GATE DR
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8130
Practice Address - Country:US
Practice Address - Phone:704-701-4976
Practice Address - Fax:704-895-9669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty