Healthcare Provider Details

I. General information

NPI: 1699514547
Provider Name (Legal Business Name): GABRIELLA ELIZABETH WARE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E ALLEN ST STE 103
HENDERSONVILLE NC
28792-5091
US

IV. Provider business mailing address

408 HIGUERA ST STE 200
SAN LUIS OBISPO CA
93401-6135
US

V. Phone/Fax

Practice location:
  • Phone: 828-417-0160
  • Fax: 828-417-3151
Mailing address:
  • Phone: 805-788-0805
  • Fax: 805-788-0845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP23183
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: