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General NPI Number Information
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NPI Number | 1639608292
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Entity Type | Individual
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Provider Name | ELIZABETH CALDWELL ZACHARYASZ DPT, ATC
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Gender | Female
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Dates
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Enumeration Date | 06/07/2017
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 6048 W HIGHWAY 74
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-3591
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Country | US
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Telephone | 704-829-9800
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Fax | 704-829-9810
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Provider Business Mailing Address
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Address Line | 6048 W HIGHWAY 74
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-3591
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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 | 2083S0010X
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Taxonomy Name | Sports Medicine (Preventive Medicine) Physician
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License Number | 2000021399
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P21015
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License Number State | NC
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