Healthcare Provider Details

I. General information

NPI: 1609857796
Provider Name (Legal Business Name): MADTES AUGHENBAUGH PHYSICAL THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 N CHURCH ST SUITE D
GREENSBORO NC
27405-5632
US

IV. Provider business mailing address

1910 N CHURCH ST SUITE D
GREENSBORO NC
27405-5632
US

V. Phone/Fax

Practice location:
  • Phone: 336-274-7480
  • Fax: 336-274-8903
Mailing address:
  • Phone: 336-274-7480
  • Fax: 336-274-8903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHERINE VARNEY
Title or Position: PRACTICE MANAGER
Credential:
Phone: 336-274-7480