Healthcare Provider Details

I. General information

NPI: 1467287854
Provider Name (Legal Business Name): GENE PERLE-JONES DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 DANA DR APT D
RALEIGH NC
27606-2346
US

IV. Provider business mailing address

5225 DANA DR APT D
RALEIGH NC
27606-2346
US

V. Phone/Fax

Practice location:
  • Phone: 720-255-3273
  • Fax:
Mailing address:
  • Phone: 720-255-3273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberP23579
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: