Basic Information
Provider Information
NPI: 1649688029
EntityType: 2
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OrganizationName: BREAKTHROUGH PHYSICAL THERAPY INC
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Mailing Information
Address1: 1910 N CHURCH ST
Address2: STE D
City: GREENSBORO
State: NC
PostalCode: 274055666
CountryCode: US
TelephoneNumber: 3362747480
FaxNumber: 3362748903
Practice Location
Address1: 1051 PEMBERTON HILL RD
Address2: SUITE 201
City: APEX
State: NC
PostalCode: 275024267
CountryCode: US
TelephoneNumber: 9193633640
FaxNumber: 9193633642
Other Information
ProviderEnumerationDate: 07/29/2014
LastUpdateDate: 11/30/2018
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AuthorizedOfficialLastName: HATHAWAY
AuthorizedOfficialFirstName: JEFFREY
AuthorizedOfficialMiddleName: W
AuthorizedOfficialTitleorPosition: PT, OWNER
AuthorizedOfficialTelephone: 6072276366
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IsOrganizationSubpart: N
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AuthorizedOfficialCredential: PT, DPT
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X  N193200000X MULTI-SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
235Z00000X  N193200000X MULTI-SPECIALTY GROUPSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist 
225100000X  Y193200000X MULTI-SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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