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1093718199

NPI Code Detail

MEDICARE: CLEVELAND PHYSICAL THERAPY ASSOCIATES INC

MEDICARE: CLEVELAND PHYSICAL THERAPY ASSOCIATES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center		NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	NC1056	OTHER	NC	SUBMITTER ID
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093718199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND PHYSICAL THERAPY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	1129 E MARION ST
Second Line	:
City	:	SHELBY
State	:	NC
Zip	:	28150-4843
Country	:	US
Telephone Number	:	704-471-0001
Fax Number	:	704-471-0004

Provider Business Practice Location Address
First Line	:	1129 E MARION ST
Second Line	:
City	:	SHELBY
State	:	NC
Zip	:	28150-4843
Country	:	US
Telephone Number	:	704-471-0001
Fax Number	:	704-471-0004

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DONALD GLENN MILLER JR.
Credential	:	DPT, MS, PT
Telephone Number	:	704-471-0001

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/22/2020

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1255385464 — MRS. AMY M HOLCOMBE PT
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Practice Fax: 704-471-0004

1447336201 — MS. APRIL F CANNON MPT
Practice Location Address:

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SHELBY, NC
28150-4843

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1194801936 — MRS. LAURA E WELLMON MPT
Practice Location Address:

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Directions to “CLEVELAND PHYSICAL THERAPY ASSOCIATES INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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