Provider Demographics
NPI:1952042673
Name:CELTIC PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:CELTIC PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EOIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLERAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-706-4321
Mailing Address - Street 1:3726 BATTLEGROUND AVE STE B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2344
Mailing Address - Country:US
Mailing Address - Phone:336-706-4321
Mailing Address - Fax:336-900-2129
Practice Address - Street 1:3726 BATTLEGROUND AVE STE B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2344
Practice Address - Country:US
Practice Address - Phone:336-706-4321
Practice Address - Fax:336-313-0973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty