Healthcare Provider Details

I. General information

NPI: 1558947614
Provider Name (Legal Business Name): APRIL HEYWORTH DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 LABELLE DR
WAXHAW NC
28173-7091
US

IV. Provider business mailing address

2409 LABELLE DR
WAXHAW NC
28173-7091
US

V. Phone/Fax

Practice location:
  • Phone: 704-779-4350
  • Fax:
Mailing address:
  • Phone: 704-779-4350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberP9804
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: