Organization
NEW CASTLE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS PETERSON PT, DPT (PHYSICAL THERAPIST, OWNER)
(423) 284-2399
Entity
Organization
Contact information
Practice address
6420 COUNTY ROAD 335 UNIT B, NEW CASTLE, CO 81647-9691
(401) 213-9842
Mailing address
501 FOREST LN, SUITE A, CLEMSON, SC 29631-2621
(864) 722-0335
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619357696
INDIVIDUAL NPI NUMBER BEFORE I CREATED THIS BUSINESS
—
Enumeration date
07/11/2020
Last updated
08/12/2020
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