Healthcare Provider Details

I. General information

NPI: 1205502614
Provider Name (Legal Business Name): GREENSBORO PHYSICAL THERAPY AND SPORTS MEDICINE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 W WENDOVER AVE
GREENSBORO NC
27408-8401
US

IV. Provider business mailing address

1309 SURRY DR
GREENSBORO NC
27408-6119
US

V. Phone/Fax

Practice location:
  • Phone: 336-274-5006
  • Fax: 336-274-5033
Mailing address:
  • Phone: 215-837-9630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. LAUREN ELIZABETH CHANDLER
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT, MS
Phone: 336-274-5006