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General NPI Number Information
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NPI Number | 1235485160
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Entity Type | Individual
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Provider Name | MARY WEDDINGTON POETKER PT
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Gender | Female
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Dates
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Enumeration Date | 07/29/2012
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Last Update Date | 07/29/2012
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Provider Practice Location Address
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Address Line | 301 10TH ST NW
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City | CONOVER
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State | NC
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Zip | 28613-2419
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Country | US
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Telephone | 828-695-6469
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Fax | 828-464-5800
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Provider Business Mailing Address
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Address Line | 2372 EAGLE DR NE
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City | CONOVER
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State | NC
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Zip | 28613-9497
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Country | US
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Telephone | 828-695-6469
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Fax | 828-464-5800
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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 | PT1892
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License Number State | NC
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