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Organization
PHYSICAL THERAPY CLINIC INC
Active
Organization
PHYSICAL THERAPY CLINIC INC
Active
Other names
The Physical Therapy Clinic, Inc., Axis Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEANNE LYON BURNS PT (PRESIDENT/OWNER/PT)
(910) 577-3355
Entity
Organization
Contact information
Practice address
26 OFFICE PARK DR, JACKSONVILLE, NC 28546
(910) 577-3355
(910) 577-4556
Mailing address
26 OFFICE PARK DR, JACKSONVILLE, NC 28546-7325
(910) 577-3355
(910) 577-4556
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4047
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0229M
BLUE CROSS & BLUE SHIELD
NC
01
—
153455500
FED W/C OWCP
NC
01
—
70592
MEDCOST
NC
Enumeration date
06/20/2006
Last updated
08/22/2018
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