NPI 1003521089 · live from the CMS NPI Registry
Activade LLC
Physical Therapist in Charlotte, NC. National Provider Identifier 1003521089, active.
NPI record
| NPI | 1003521089 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 809 Woodruff Pl, Charlotte, NC 28208 |
| Practice phone | 704-839-2019 |
| Enumerated | January 13, 2023 |
| Last updated | January 13, 2023 |
| Authorized official | Kenneth Corcoran, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapist primary | 225100000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.