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NPI Code Detail

MEDICARE: PHYSICAL THERAPY OF LEICESTER INC

MEDICARE: PHYSICAL THERAPY OF LEICESTER 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
1225100000XPhysical TherapistNC8787NC

General Provider Information

NPI Number : 1770781270
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICAL THERAPY OF LEICESTER INC
Provider Business Mailing Address
First Line : 149 NEW LEICESTER HWY
Second Line :
City : ASHEVILLE
State : NC
Zip : 28806-1917
Country : US
Telephone Number : 828-225-3838
Fax Number : 828-225-3839
Provider Business Practice Location Address
First Line : 149 NEW LEICESTER HWY
Second Line :
City : ASHEVILLE
State : NC
Zip : 28806-1917
Country : US
Telephone Number : 828-225-3838
Fax Number : 828-225-3839
Authorized Official
Title or Position : PRESIDENT
Name : DAMON G ROUSE
Credential : PT
Telephone Number : 828-225-3838
Provider Enumeration Date : 07/05/2007
Last Update Date : 07/25/2013

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1811395957 — DIANNE SORENSEN PT
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1144757584 — DR. RACHEL L SHUMATE PT, DPT
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Directions to “PHYSICAL THERAPY OF LEICESTER INC ” Practice Location

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