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General NPI Number Information
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NPI Number | 1942743646
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Entity Type | Organization
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Legal Business Name | BODY LOGIC INTEGRATIVE PHYSICAL THERAPY
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Dates
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Enumeration Date | 11/29/2016
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Last Update Date | 12/08/2017
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Provider Practice Location Address
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Address Line | 2 WEAVERVILLE RD STE 101
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City | WOODFIN
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State | NC
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Zip | 28804-1388
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Country | US
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Telephone | 828-424-9290
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Fax | 828-417-7103
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Provider Business Mailing Address
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Address Line | PO BOX 18801
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City | ASHEVILLE
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State | NC
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Zip | 28814-0801
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Country | US
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Telephone | 828-424-9290
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Fax | 828-417-7103
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Authorized Official
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Title or Position | OWNER
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Name | PHILLIP D. ROLFE
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Credential | PT, DPT, ATC
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Telephone | 828-424-9290
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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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