Healthcare Provider Details

I. General information

NPI: 1225784630
Provider Name (Legal Business Name): MARY FRANCES-LUCAS ZIEMBA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 OLD ORCHARD LN
GREENSBORO NC
27455-1394
US

IV. Provider business mailing address

15 OLD ORCHARD LN
GREENSBORO NC
27455-1394
US

V. Phone/Fax

Practice location:
  • Phone: 336-508-1430
  • Fax: 855-232-8604
Mailing address:
  • Phone: 336-508-1430
  • Fax: 855-232-8604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP4544
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: