Provider Demographics
NPI:1982923686
Name:IN HOME PHYSICAL THERAPY AND WELLNESS OF MEBANE LLC
Entity Type:Organization
Organization Name:IN HOME PHYSICAL THERAPY AND WELLNESS OF MEBANE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:BYRNES
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:336-269-8187
Mailing Address - Street 1:119 STONEHAM RD
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-9641
Mailing Address - Country:US
Mailing Address - Phone:336-269-8187
Mailing Address - Fax:888-705-7429
Practice Address - Street 1:119 STONEHAM RD
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-9641
Practice Address - Country:US
Practice Address - Phone:336-269-8187
Practice Address - Fax:888-705-7429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6225261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy