Healthcare Provider Details

I. General information

NPI: 1306060280
Provider Name (Legal Business Name): HARMON PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 LANIER AVENUE
ASHEBORO NC
27205
US

IV. Provider business mailing address

304 LANIER AVENUE
ASHEBORO NC
27205
US

V. Phone/Fax

Practice location:
  • Phone: 336-629-0086
  • Fax: 336-629-0098
Mailing address:
  • Phone: 336-629-0086
  • Fax: 336-629-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7415
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL HARMON
Title or Position: OWNER
Credential: MPT
Phone: 336-629-0086