Provider Demographics
NPI:1396420915
Name:SPECIALIZED PHYSICAL AND OCCUPATIONAL THERAPY
Entity type:Organization
Organization Name:SPECIALIZED PHYSICAL AND OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRAGGS-YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-817-3224
Mailing Address - Street 1:PO BOX 688
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:NC
Mailing Address - Zip Code:28773-0688
Mailing Address - Country:US
Mailing Address - Phone:828-817-3224
Mailing Address - Fax:
Practice Address - Street 1:155 W MILLS ST STE 104
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-9426
Practice Address - Country:US
Practice Address - Phone:828-817-3224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty