Healthcare Provider Details

I. General information

NPI: 1164991402
Provider Name (Legal Business Name): ARRYN KASEY GAMBLE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4140 RAMSEY ST STE 110
FAYETTEVILLE NC
28311-7658
US

IV. Provider business mailing address

981 HIGH HOUSE RD STE 100
CARY NC
27513-3510
US

V. Phone/Fax

Practice location:
  • Phone: 910-483-9300
  • Fax: 910-483-9302
Mailing address:
  • Phone: 919-388-0111
  • Fax: 919-388-8668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60865226
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP20565
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: