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Organization
PHYSICAL THERAPY SERVICES OF WILMINGTON
Active
Organization
PHYSICAL THERAPY SERVICES OF WILMINGTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT ALAN SIMMERMAN PT (OWNER)
(910) 763-8286
Entity
Organization
Contact information
Practice address
1776 S 17TH ST, WILMINGTON, NC 28401-6442
(910) 763-8286
(910) 251-9289
Mailing address
1776 S 17TH ST, WILMINGTON, NC 28401-6442
(910) 763-8286
(910) 251-9289
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NC
225XH1200X
Hand Occupational Therapist
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176F
BCBS OF NC
NC
05
—
7210839
—
NC
01
—
L2827
RAILROAD MEDICARE
NC
Enumeration date
04/19/2007
Last updated
08/14/2007
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