Calvin Clay

Individual provider Active NPI Physical Therapy Assistant · Ellenboro, NC

NPI 1750719720 · NPPES record last updated Oct 29, 2013

Key facts

NPI
1750719720
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
A4507 (NC)
Practice address
135 High Cotton Dr
Ellenboro, NC 28040-7322
Phone
(828) 453-8181
NPI assigned
Oct 29, 2013
Sex
Male
Sole proprietor
No

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
A4507NCMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A4507 NC Yes

Addresses

Primary practice location

135 High Cotton Dr
Ellenboro, NC 28040-7322

Mailing address

135 High Cotton Dr
Ellenboro, NC 28040-7322
Phone (828) 453-8181

Other providers in Ellenboro, NC

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

Sources for this page

Verify at the official NPI Registry.