Healthcare Provider Details
I. General information
NPI: 1912603135
Provider Name (Legal Business Name): FACTOR PHYSIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/31/2023
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1101 E WHITAKER MILL RD STE 165
RALEIGH NC
27604-5357
US
IV. Provider business mailing address
1101 E WHITAKER MILL RD STE 165
RALEIGH NC
27604-5357
US
V. Phone/Fax
- Phone: 919-548-7807
- Fax:
- Phone: 919-548-7807
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SARAH
LEONARD
Title or Position: OWNER AND PHYSICAL THERAPIST
Credential: DPT, PT, CSCS
Phone: 919-548-7807