Provider Demographics
NPI:1205502614
Name:GREENSBORO PHYSICAL THERAPY AND SPORTS MEDICINE SERVICES
Entity type:Organization
Organization Name:GREENSBORO PHYSICAL THERAPY AND SPORTS MEDICINE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MS
Authorized Official - Phone:336-274-5006
Mailing Address - Street 1:1309 SURRY DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-6119
Mailing Address - Country:US
Mailing Address - Phone:215-837-9630
Mailing Address - Fax:
Practice Address - Street 1:319 W WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-8401
Practice Address - Country:US
Practice Address - Phone:336-274-5006
Practice Address - Fax:336-274-5033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty