Basic Information
| Provider Information | |||||||||
| NPI: | 1003003385 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HANDS ON PHYSICAL THERAPY, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 530 W GANNON AVE | ||||||||
| Address2: | |||||||||
| City: | ZEBULON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275972510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192690107 | ||||||||
| FaxNumber: | 9192690207 | ||||||||
| Practice Location | |||||||||
| Address1: | 530 W GANNON AVE | ||||||||
| Address2: | |||||||||
| City: | ZEBULON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275972510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192690107 | ||||||||
| FaxNumber: | 9192690207 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2007 | ||||||||
| LastUpdateDate: | 02/07/2008 | ||||||||
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| AuthorizedOfficialLastName: | TURNBAUGH | ||||||||
| AuthorizedOfficialFirstName: | LISA | ||||||||
| AuthorizedOfficialMiddleName: | DIANE | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9192690107 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HANDS ON PHYSICAL THERAPY | ||||||||
| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | 0700001290 | NC | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
ID Information
| ID | Type | State | Issuer | Description | 0253V | 01 | NC | BLUE CROSS BLUE SHIELD | OTHER |