Provider Demographics
NPI:1912494220
Name:CHAIN EFFECT PHYSICAL THERAPY AND PERFORMANCE ENHANCEMENT
Entity type:Organization
Organization Name:CHAIN EFFECT PHYSICAL THERAPY AND PERFORMANCE ENHANCEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-847-4547
Mailing Address - Street 1:2501 BLUE RIDGE RD STE G130
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6347
Mailing Address - Country:US
Mailing Address - Phone:917-847-4547
Mailing Address - Fax:
Practice Address - Street 1:2501 BLUE RIDGE RD STE G130
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6347
Practice Address - Country:US
Practice Address - Phone:917-847-4547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty