Ted Kupsick

Individual provider Active NPI Physical Therapy Assistant · Biscoe, NC

NPI 1487168779 · NPPES record last updated Nov 22, 2017

Key facts

NPI
1487168779
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
5124 (NC)
Practice address
401 Lambert Rd
Biscoe, NC 27209-9002
Phone
(910) 428-2117
NPI assigned
Nov 22, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5124NCMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5124 NC Yes

Addresses

Primary practice location

401 Lambert Rd
Biscoe, NC 27209-9002

Mailing address

1637 Trotters Ridge Rd
Stanfield, NC 28163-9310
Phone (704) 244-1490

Other providers in Biscoe, NC

All providers in Biscoe, NC · Physical Therapy Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.