Healthcare Provider Details
I. General information
NPI: 1578375622
Provider Name (Legal Business Name): JAMES D GADUE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/24/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
171 OLD HIGHWAY 58 STE 5
CEDAR POINT NC
28584-9342
US
IV. Provider business mailing address
1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US
V. Phone/Fax
- Phone: 252-324-4695
- Fax: 252-324-4696
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | P23835 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: