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General NPI Number Information
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NPI Number | 1487663654
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Entity Type | Organization
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Legal Business Name | IN FORM HEALTHCARE, INC
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Dates
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Enumeration Date | 08/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 403 PARKWAY
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City | GREENSBORO
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State | NC
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Zip | 27401-1652
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Country | US
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Telephone | 336-317-9233
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Fax |
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Provider Business Mailing Address
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Address Line | 403 E PARKWAY
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City | GREENSBORO
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State | NC
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Zip | 27401-1652
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Country | US
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Telephone | 336-317-9233
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ASHU CHOPRA
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Credential |
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Telephone | 336-761-5066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 346641
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License Number State | NC
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