Provider Demographics
NPI:1194260919
Name:COMPASS PHYSICAL THERAPY
Entity type:Organization
Organization Name:COMPASS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KEVERN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, SCS
Authorized Official - Phone:828-808-5662
Mailing Address - Street 1:2170 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-5704
Mailing Address - Country:US
Mailing Address - Phone:828-808-5662
Mailing Address - Fax:
Practice Address - Street 1:2170 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704
Practice Address - Country:US
Practice Address - Phone:828-490-4499
Practice Address - Fax:828-348-5485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP9721261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy