Provider Demographics
NPI:1942189402
Name:PRO-ACTIVE PT
Entity type:Organization
Organization Name:PRO-ACTIVE PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARRETT
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:704-502-5553
Mailing Address - Street 1:520 NANNY POINT DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-7664
Mailing Address - Country:US
Mailing Address - Phone:704-502-5533
Mailing Address - Fax:
Practice Address - Street 1:520 NANNY POINT DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7664
Practice Address - Country:US
Practice Address - Phone:704-502-5533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy