Healthcare Provider Details

I. General information

NPI: 1629013909
Provider Name (Legal Business Name): JOYCE ZAINE KIGHT LPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8025 CORPORATE CENTER DR SUITE 200
CHARLOTTE NC
28226-4499
US

IV. Provider business mailing address

PO BOX 472956
CHARLOTTE NC
28247-2956
US

V. Phone/Fax

Practice location:
  • Phone: 704-541-1191
  • Fax: 704-541-1192
Mailing address:
  • Phone: 704-541-1191
  • Fax: 704-541-1192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2251
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2129
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: