Healthcare Provider Details

I. General information

NPI: 1528144391
Provider Name (Legal Business Name): ERIK J VRANESH DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 E MARION ST
SHELBY NC
28150-4843
US

IV. Provider business mailing address

1129 E MARION ST
SHELBY NC
28150-4843
US

V. Phone/Fax

Practice location:
  • Phone: 704-471-0001
  • Fax: 704-471-0004
Mailing address:
  • Phone: 704-471-0001
  • Fax: 704-471-0004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP10374
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: