Healthcare Provider Details

I. General information

NPI: 1316402233
Provider Name (Legal Business Name): MARK POWELL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2019
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 JACK BRANCH DRIVE
BOONE NC
28608-0001
US

IV. Provider business mailing address

135 JACK BRANCH DRIVE
BOONE NC
28608-5057
US

V. Phone/Fax

Practice location:
  • Phone: 828-266-0030
  • Fax: 828-398-4539
Mailing address:
  • Phone: 828-266-0030
  • Fax: 828-398-4539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: