Provider Demographics
NPI:1942743646
Name:BODY LOGIC INTEGRATIVE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:BODY LOGIC INTEGRATIVE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROLFE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, ATC
Authorized Official - Phone:828-424-9290
Mailing Address - Street 1:PO BOX 18801
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28814-0801
Mailing Address - Country:US
Mailing Address - Phone:828-424-9290
Mailing Address - Fax:828-417-7103
Practice Address - Street 1:2 WEAVERVILLE RD STE 101
Practice Address - Street 2:
Practice Address - City:WOODFIN
Practice Address - State:NC
Practice Address - Zip Code:28804-1388
Practice Address - Country:US
Practice Address - Phone:828-424-9290
Practice Address - Fax:828-417-7103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty