Healthcare Provider Details

I. General information

NPI: 1083743280
Provider Name (Legal Business Name): VICTORIA A. GUTHRIE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ERWIN RD
DURHAM NC
27705-4504
US

IV. Provider business mailing address

1829 E FRANKLIN ST BLDG. # 600
CHAPEL HILL NC
27514-5861
US

V. Phone/Fax

Practice location:
  • Phone: 919-668-3029
  • Fax:
Mailing address:
  • Phone: 919-968-3456
  • Fax: 919-932-3456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number4639
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: