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Organization
MAIN STREET PHYSICAL THERAPY INC
Active
Organization
MAIN STREET PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW S JETER DC (OWNER)
(704) 633-5156
Entity
Organization
Contact information
Practice address
1001 N MAIN ST, SALISBURY, NC 28144-3611
(704) 633-5156
(704) 637-3955
Mailing address
1001 N MAIN ST, SALISBURY, NC 28144-3611
(704) 633-5156
(704) 637-3955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P8568
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2045
MEDICAL LICENSE
NC
Enumeration date
11/21/2014
Last updated
11/21/2014
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