MEDICARE: CHARISSE GALANIDA 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
1	225100000X	Physical Therapist	10096	NC

General Provider Information

NPI Number	:	1912230343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARISSE GALANIDA PT

Provider Business Mailing Address
First Line	:	3150 N ELM ST
Second Line	:	#102
City	:	GREENSBORO
State	:	NC
Zip	:	27408-3880
Country	:	US
Telephone Number	:	336-288-1181
Fax Number	:

Provider Business Practice Location Address
First Line	:	3150 N ELM ST
Second Line	:	#102
City	:	GREENSBORO
State	:	NC
Zip	:	27408-3880
Country	:	US
Telephone Number	:	336-288-1181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2009
Last Update Date	:	03/14/2017

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