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NPI Code Detail

MEDICARE: MRS. BROOKE WALDROUP-COATS LPTA

MEDICARE: MRS. BROOKE WALDROUP-COATS LPTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant3670NC

General Provider Information

NPI Number : 1396903316
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BROOKE WALDROUP-COATS LPTA
Provider Business Mailing Address
First Line : 95 HOLCOMBE COVE RD
Second Line :
City : CANDLER
State : NC
Zip : 28715-9450
Country : US
Telephone Number : 828-667-9851
Fax Number :
Provider Business Practice Location Address
First Line : 95 HOLCOMBE COVE RD
Second Line :
City : CANDLER
State : NC
Zip : 28715-9450
Country : US
Telephone Number : 828-667-9851
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2008
Last Update Date : 05/27/2008

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Directions to “ MRS. BROOKE WALDROUP-COATS LPTA” Practice Location

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