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NPI Code Detail

MEDICARE: DEXTER A TE PT

MEDICARE: DEXTER A TE 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
12251X0800XOrthopedic Physical Therapist40QA01055200NJ
2225100000XPhysical Therapist24358MD

General Provider Information

NPI Number : 1780610188
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEXTER A TE PT
Provider Business Mailing Address
First Line : 350 NEW FIDELITY CT
Second Line :
City : GARNER
State : NC
Zip : 27529-2665
Country : US
Telephone Number : 919-258-2714
Fax Number : 410-648-4878
Provider Business Practice Location Address
First Line : 7629 BELAIR RD
Second Line :
City : NOTTINGHAM
State : MD
Zip : 21236-4003
Country : US
Telephone Number : 410-870-2104
Fax Number : 410-870-6896
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2006
Last Update Date : 05/10/2022

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Directions to “ DEXTER A TE PT” Practice Location

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