Provider Demographics
NPI:1730374810
Name:CRAVEN PHYSICAL THERAPY & SPINE, INC
Entity type:Organization
Organization Name:CRAVEN PHYSICAL THERAPY & SPINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAMADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-638-5120
Mailing Address - Street 1:2111 NEUSE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-4317
Mailing Address - Country:US
Mailing Address - Phone:252-638-5120
Mailing Address - Fax:252-638-5120
Practice Address - Street 1:2111 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4317
Practice Address - Country:US
Practice Address - Phone:252-638-5120
Practice Address - Fax:252-638-5120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty