Healthcare Provider Details

I. General information

NPI: 1679549042
Provider Name (Legal Business Name): STEPHEN C. HELTON I PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 06/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 MILLSTONE DR
HILLSBOROUGH NC
27278-8642
US

IV. Provider business mailing address

401 MEADOWLANDS DR STE 101
HILLSBOROUGH NC
27278-8134
US

V. Phone/Fax

Practice location:
  • Phone: 919-522-3976
  • Fax: 919-751-9170
Mailing address:
  • Phone: 919-491-4248
  • Fax: 866-605-6675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2176
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: