Healthcare Provider Details

I. General information

NPI: 1134770266
Provider Name (Legal Business Name): CASIE MARIE GAYTON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASIE DAMORE

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 CEDAR POINT BLVD STE M
CEDAR POINT NC
28584-1030
US

IV. Provider business mailing address

1165 CEDAR POINT BLVD STE M
CEDAR POINT NC
28584-1030
US

V. Phone/Fax

Practice location:
  • Phone: 252-499-7650
  • Fax: 252-764-2442
Mailing address:
  • Phone: 252-499-7650
  • Fax: 252-764-2442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP25211
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: