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NPI Code Detail

MEDICARE: TIFFANY FLETCHER POOLE PT

MEDICARE: TIFFANY FLETCHER POOLE PT
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 Therapist13778NC

General Provider Information

NPI Number : 1457601429
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY FLETCHER POOLE PT
Provider Business Mailing Address
First Line : 1375 COWELL FARM RD
Second Line :
City : WASHINGTON
State : NC
Zip : 27889-3495
Country : US
Telephone Number : 252-975-4395
Fax Number : 252-975-4112
Provider Business Practice Location Address
First Line : 2100 STANTONSBURG RD
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-2818
Country : US
Telephone Number : 252-943-0600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2012
Last Update Date : 05/06/2021

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Directions to “ TIFFANY FLETCHER POOLE PT” Practice Location

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