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NPI Code Detail

MEDICARE: CASSONDRA JO WARDLE DPT

MEDICARE: CASSONDRA JO WARDLE DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistP23483NC

General Provider Information

NPI Number : 1093578395
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSONDRA JO WARDLE DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 16139 LANCASTER HWY STE 140
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-2976
Country : US
Telephone Number : 704-542-2492
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2024
Last Update Date : 02/10/2026

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