Provider Demographics
NPI:1790451078
Name:START PHYSICAL THERAPY
Entity Type:Organization
Organization Name:START PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-594-1030
Mailing Address - Street 1:7 E OAK BRANCH DR.
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2380
Mailing Address - Country:US
Mailing Address - Phone:336-294-0910
Mailing Address - Fax:336-218-0294
Practice Address - Street 1:8320 LITCHFORD RD SUITE 140
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615
Practice Address - Country:US
Practice Address - Phone:919-594-1030
Practice Address - Fax:919-594-1022
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE PHYSICAL THERAPY CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty