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General NPI Number Information
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NPI Number | 1912494220
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Entity Type | Organization
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Legal Business Name | CHAIN EFFECT PHYSICAL THERAPY AND PERFORMANCE ENHANCEMENT
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 04/23/2018
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Provider Practice Location Address
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Address Line | 2501 BLUE RIDGE RD STE G130
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City | RALEIGH
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State | NC
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Zip | 27607-6347
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Country | US
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Telephone | 917-847-4547
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 BLUE RIDGE RD STE G130
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City | RALEIGH
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State | NC
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Zip | 27607-6347
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Country | US
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Telephone | 917-847-4547
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | TAYLOR POPE
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Credential | PT
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Telephone | 917-847-4547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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