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NPI 1730265588

NPI 1730265588 : MARK MIELE MPT : GASTONIA, NC

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General NPI Number Information
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    NPI Number           |    1730265588
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    Entity Type          |    Individual 
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    Provider Name        |    MARK MIELE MPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/27/2006
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    Last Update Date     |    08/04/2025
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Provider Practice Location Address
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    Address Line         |    870 SUMMIT CROSSING PL 
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    City                 |    GASTONIA
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    State                |    NC
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    Zip                  |    28054-2192
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    Country              |    US
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    Telephone            |    704-671-1860
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4601 PARK RD SUITE 300
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28209-3239
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    Country              |    US
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    Telephone            |    704-323-2000
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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       |    P7540
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    License Number State |    NC
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