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Organization

PORT CITY PHYSICAL THERAPY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD ROYCE JARBOE PT (PRESIDENT/CEO)
(910) 763-7674
Entity
Organization

Contact information

Practice address
321 N FRONT ST, WILMINGTON, NC 28401-3908
(910) 763-7674
(910) 763-8533
Mailing address
321 N FRONT ST, WILMINGTON, NC 28401-3908
(910) 763-7674
(910) 763-8533

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
1796
NC
225100000X
Physical Therapist
2549
NC
2251X0800X
Orthopedic Physical Therapist
Primary
2549
NC
225700000X
Massage Therapist
173
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
173
NC MASSAGE THERAPIST LIC#
NC
01
1821190075
INDIVIDUAL NPI NUMBER
NC
01
2549
NC PT LICENSE NUMBER
NC
05
7200115
NC
05
7210534
NC
Enumeration date
10/11/2006
Last updated
09/30/2008
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