Organization
ADVANCED THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LEATHERMAN (PT MANAGER)
(336) 665-8445
Entity
Organization
Contact information
Practice address
414 GALLIMORE DAIRY RD, SUITE B, GREENSBORO, NC 27409-9509
(336) 665-8445
Mailing address
8300 FALLS OF NEUSE RD, SUITE 104, RALEIGH, NC 27615-3449
(919) 846-9668
(919) 846-9663
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8012
—
Other
Enumeration date
02/16/2007
Last updated
08/22/2020
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