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General NPI Number Information
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NPI Number | 1770085581
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Entity Type | Individual
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Provider Name | JESSICA BURKHART ANASTOPOULOS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 03/07/2018
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 801 MEADOWOOD ST
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City | GREENSBORO
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State | NC
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Zip | 27409-2838
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Country | US
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Telephone | 919-424-5078
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Fax |
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Provider Business Mailing Address
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Address Line | 4620 JAMES CROSSING DR
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City | JAMESTOWN
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State | NC
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Zip | 27282-8694
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Country | US
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Telephone | 336-688-1310
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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 | P17711
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License Number State | NC
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