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General NPI Number Information
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NPI Number | 1174118467
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Entity Type | Organization
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Legal Business Name | FRONTLINE ORTHOPEDIC PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/08/2021
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Last Update Date | 03/08/2021
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Provider Practice Location Address
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Address Line | 231 GOVERNMENT AVE SW UNIT 2974
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City | HICKORY
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State | NC
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Zip | 28603-5519
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Country | US
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Telephone | 828-781-0217
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Fax |
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Provider Business Mailing Address
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Address Line | 231 GOVERNMENT AVE SW UNIT 2974
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City | HICKORY
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State | NC
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Zip | 28603-5519
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Country | US
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Telephone | 828-781-0217
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | NEORLAN TRUJILLO
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Credential | PT, DPT, OCS
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Telephone | 828-781-0217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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