Provider Demographics
NPI:1235936899
Name:CONCIERGE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:CONCIERGE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:NUTT
Authorized Official - Suffix:II
Authorized Official - Credentials:DPT
Authorized Official - Phone:740-605-6881
Mailing Address - Street 1:9708 COLT DR
Mailing Address - Street 2:
Mailing Address - City:BAHAMA
Mailing Address - State:NC
Mailing Address - Zip Code:27503-9699
Mailing Address - Country:US
Mailing Address - Phone:336-739-3430
Mailing Address - Fax:
Practice Address - Street 1:9708 COLT DR
Practice Address - Street 2:
Practice Address - City:BAHAMA
Practice Address - State:NC
Practice Address - Zip Code:27503-9699
Practice Address - Country:US
Practice Address - Phone:740-605-6881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy