=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124491196
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WENDY L ABEE PTA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2015
-----------------------------------------------------
Last Update Date | 11/12/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2030 HARPER AVE NW
-----------------------------------------------------
City | LENOIR
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28645-4953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-754-3888
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2030 HARPER AVE NW
-----------------------------------------------------
City | LENOIR
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28645-4953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 182-875-4388
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | 4106
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------