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General NPI Number Information
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NPI Number | 1669431003
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Entity Type | Individual
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Provider Name | AMY DIANE MIERZWA DPT
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Gender | Female
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 02/14/2013
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Provider Practice Location Address
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Address Line | 7239 PINEVILLE MATTHEWS RD SUITE 400
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City | CHARLOTTE
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State | NC
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Zip | 28226-6153
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Country | US
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Telephone | 980-224-7958
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Fax | 980-224-7973
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Provider Business Mailing Address
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Address Line | 7239 PINEVILLE MATTHEWS RD SUITE 400
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City | CHARLOTTE
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State | NC
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Zip | 28226-6153
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Country | US
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Telephone | 980-224-7958
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Fax | 980-224-7973
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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 | 7528
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License Number State | NC
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