Organization
PHYSICAL THERAPY AND HAND SPECIALIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KILEY RUSSELL (MANAGER OF PROVIDER AND PAYER ENROL)
(423) 238-8923
Entity
Organization
Contact information
Practice address
610 N FAYETTEVILLE ST STE 201, ASHEBORO, NC 27203-4671
(336) 633-4263
(336) 633-4267
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
03/04/2014
Last updated
03/04/2014
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