| Organization Name: | BLACK MOUNTAIN PHYSICAL THERAPY, LLC |
| NPI Number: | 1457696361 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLIFFORD SHULMAN (OWNER) |
| Mailing Address: | 997 W Old Us 70 Hwy Black Mountain |
| State: | NC US |
| Postal Code: | 28711 |
| Phone Number: | 8286696896 |
| Fax Number: | 8286696897 |
| NPI Enumeration Date: | 12/04/2012 |
| NPI Last Update Date: | 12/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 11251 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |