Healthcare Provider Details

I. General information

NPI: 1558135152
Provider Name (Legal Business Name): HAYLEY SAVANNAH DIAZ PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2557 PEMBROKE RD
GASTONIA NC
28054-4712
US

IV. Provider business mailing address

229 CRAMERTON MILLS PKWY
CRAMERTON NC
28032-0030
US

V. Phone/Fax

Practice location:
  • Phone: 980-320-8275
  • Fax:
Mailing address:
  • Phone: 224-567-9736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP22782
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: