Provider Demographics
NPI:1023577970
Name:INTEGRATED PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:INTEGRATED PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-663-7772
Mailing Address - Street 1:300 REGENT PARK CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6547
Mailing Address - Country:US
Mailing Address - Phone:864-437-8930
Mailing Address - Fax:864-309-8004
Practice Address - Street 1:300 REGENT PARK CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6547
Practice Address - Country:US
Practice Address - Phone:864-437-8930
Practice Address - Fax:864-309-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty