Healthcare Provider Details

I. General information

NPI: 1629980503
Provider Name (Legal Business Name): WENDI SU
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 HEALTHPLEX WAY STE 206
APEX NC
27502-8403
US

IV. Provider business mailing address

65 LILA DR
PITTSBORO NC
27312-1804
US

V. Phone/Fax

Practice location:
  • Phone: 919-232-5020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP25173
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: