Healthcare Provider Details
I. General information
NPI: 1528693793
Provider Name (Legal Business Name): CHERYL LYNN BRAMLETT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/09/2020
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 DUNDAS CIR STE B
GREENSBORO NC
27407-1638
US
IV. Provider business mailing address
1082 DAYLILLY CT
KERNERSVILLE NC
27284-9972
US
V. Phone/Fax
- Phone: 336-294-3338
- Fax: 336-294-6696
- Phone: 501-681-9044
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | P17034 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | P17034 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: