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General NPI Number Information
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NPI Number | 1982923686
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Entity Type | Organization
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Legal Business Name | IN HOME PHYSICAL THERAPY AND WELLNESS OF MEBANE LLC
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 119 STONEHAM RD
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City | MEBANE
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State | NC
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Zip | 27302-9641
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Country | US
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Telephone | 336-269-8187
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Fax | 888-705-7429
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Provider Business Mailing Address
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Address Line | 119 STONEHAM RD
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City | MEBANE
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State | NC
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Zip | 27302-9641
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Country | US
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Telephone | 336-269-8187
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Fax | 888-705-7429
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL PATRICK BYRNES
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Credential | PHYSICAL THERAPIST
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Telephone | 336-269-8187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 6225
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License Number State | NC
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