Basic Information
| Provider Information | |||||||||
| NPI: | 1740237395 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEMIS | ||||||||
| FirstName: | CALEB | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19 LAKE AVE | ||||||||
| Address2: | |||||||||
| City: | BLACK MOUNTAIN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287113071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7062678019 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15 JANE JACOBS RD | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | BLACK MOUNTAIN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287116306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286698643 | ||||||||
| FaxNumber: | 8286698648 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2006 | ||||||||
| LastUpdateDate: | 05/04/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT007931 | GA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 11388 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.