Organization
BACK TO WELLNESS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC CHARLES MODICA DPT (OWNER/ OPERATOR/PHYSICAL THERAPIST)
(828) 333-1250
Entity
Organization
Contact information
Practice address
123D ACTON CIR, ASHEVILLE, NC 28806-1043
(828) 278-4078
(828) 278-4065
Mailing address
105 CASTLEROCK DR, ASHEVILLE, NC 28806-9517
(828) 333-1250
(828) 278-4065
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119152270
CAQH
—
Enumeration date
05/11/2022
Last updated
05/11/2022
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