Provider Demographics
NPI:1548947336
Name:INTEGRATED PHYSICAL THERAPY INCORPORATED
Entity type:Organization
Organization Name:INTEGRATED PHYSICAL THERAPY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:JOHNSTON
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:919-306-0222
Mailing Address - Street 1:117 VANDORA HILLS PL
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-5423
Mailing Address - Country:US
Mailing Address - Phone:919-306-0222
Mailing Address - Fax:
Practice Address - Street 1:6512 SIX FORKS RD STE 601A
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6528
Practice Address - Country:US
Practice Address - Phone:919-306-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy