Healthcare Provider Details

I. General information

NPI: 1164860169
Provider Name (Legal Business Name): MANUAL PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 NASH ST N
WILSON NC
27896-1231
US

IV. Provider business mailing address

3200 NASH ST N
WILSON NC
27896-1231
US

V. Phone/Fax

Practice location:
  • Phone: 252-243-6784
  • Fax: 252-243-6782
Mailing address:
  • Phone: 252-243-6784
  • Fax: 252-243-6782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1891757548
Identifier TypeOTHER
Identifier State
Identifier IssuerPERSONAL NPI #

VIII. Authorized Official

Name: DR. KELLY SENGLAR-VITALE
Title or Position: PRESIDENT/OWNER
Credential: PT DPT
Phone: 252-544-0628