Provider Demographics
NPI:1821183492
Name:BRAY-MANESS PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:BRAY-MANESS PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ZIEMBA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:336-626-6382
Mailing Address - Street 1:350 N COX ST
Mailing Address - Street 2:SUITE 28
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203
Mailing Address - Country:US
Mailing Address - Phone:336-626-6382
Mailing Address - Fax:336-626-7442
Practice Address - Street 1:350 N COX ST
Practice Address - Street 2:SUITE 28
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203
Practice Address - Country:US
Practice Address - Phone:336-626-6382
Practice Address - Fax:336-626-7442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC397225100000X
NC4375261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC720778CMedicaid
NC250082BMedicare ID - Type Unspecified