Healthcare Provider Details

I. General information

NPI: 1487691390
Provider Name (Legal Business Name): YADKIN PHYSICAL THERAPY, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 WOODLYN DR
YADKINVILLE NC
27055-6673
US

IV. Provider business mailing address

102 WOODLYN DR
YADKINVILLE NC
27055-6673
US

V. Phone/Fax

Practice location:
  • Phone: 336-677-1800
  • Fax: 336-677-1802
Mailing address:
  • Phone: 336-677-1800
  • Fax: 336-677-1802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KALEB A HILL
Title or Position: OWNER/PT
Credential:
Phone: 336-677-1800