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General NPI Number Information
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NPI Number | 1407720972
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Entity Type | Individual
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Provider Name | JEFFREY AARON SANTOS
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Gender | Male
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 2040 MILTON RD
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City | CHARLOTTE
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State | NC
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Zip | 28215-3317
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Country | US
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Telephone | 704-405-0730
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Fax |
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Provider Business Mailing Address
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Address Line | 12418 BLOSSOMING CT
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City | CHARLOTTE
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State | NC
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Zip | 28273-6952
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 11163
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License Number State | NC
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