Provider Demographics
NPI:1295458297
Name:THE NEURO THERAPIST LLC
Entity type:Organization
Organization Name:THE NEURO THERAPIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ERICKSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:904-504-3449
Mailing Address - Street 1:42 VANCE CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-3011
Mailing Address - Country:US
Mailing Address - Phone:904-504-3449
Mailing Address - Fax:
Practice Address - Street 1:42 VANCE CRESCENT ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-3011
Practice Address - Country:US
Practice Address - Phone:904-504-3449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy