MEDICARE: JOE GRAY CARPENTER PT, DPT,OCS, FAAOMPT

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
1	225100000X	Physical Therapist	P2530	NC

General Provider Information

NPI Number	:	1730578402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE GRAY CARPENTER PT, DPT,OCS, FAAOMPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-405-6344
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 E MEADOW RD STE 3
Second Line	:
City	:	EDEN
State	:	NC
Zip	:	27288-3469
Country	:	US
Telephone Number	:	336-627-3771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2015
Last Update Date	:	09/10/2024

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