Provider Demographics
NPI:1982114567
Name:METHOD MANUAL PHYSICAL THERAPY AND WELLNESS LLC
Entity Type:Organization
Organization Name:METHOD MANUAL PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:METHOD PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WESTBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:252-340-9187
Mailing Address - Street 1:9244 MIRANDA DRIVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617
Mailing Address - Country:US
Mailing Address - Phone:252-340-9187
Mailing Address - Fax:
Practice Address - Street 1:9244 MIRANDA DRIVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617
Practice Address - Country:US
Practice Address - Phone:252-340-9187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPT10180225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty