Basic Information
| Provider Information | |||||||||
| NPI: | 1578231882 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PT SOLUTIONS OF NORTH CAROLINA LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 CIRCLE 75 PKWY SE STE 1400 | ||||||||
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| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303393067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6789813543 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7560 CARPENTER FIRE STATION RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275199650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192345526 | ||||||||
| FaxNumber: | 9842083631 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2021 | ||||||||
| LastUpdateDate: | 09/01/2021 | ||||||||
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| AuthorizedOfficialLastName: | GAYLORD | ||||||||
| AuthorizedOfficialFirstName: | ANNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6789813543 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225100000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.