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General NPI Number Information
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NPI Number | 1174487540
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Entity Type | Individual
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Provider Name | MAITRI DAVE PT
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Gender | Female
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 6437 OLD MONROE RD STE E
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-5415
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Country | US
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Telephone | 704-686-7767
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Fax | 704-686-7732
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Provider Business Mailing Address
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Address Line | 185 LONGLEAF DR
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City | MOORESVILLE
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State | NC
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Zip | 28117-9551
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P24517
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License Number State | NC
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