Healthcare Provider Details

I. General information

NPI: 1154616738
Provider Name (Legal Business Name): HOPE FOX COLE MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 WOODLYN DR
YADKINVILLE NC
27055-6673
US

IV. Provider business mailing address

102 WOODLYN DR
YADKINVILLE NC
27055-6673
US

V. Phone/Fax

Practice location:
  • Phone: 336-677-1800
  • Fax: 336-677-1802
Mailing address:
  • Phone: 336-677-1800
  • Fax: 336-677-1802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12062
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: