Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | P14386 | NC |
N | 225200000X | Physical Therapy Assistant |
NPI | 1003327271 |
---|---|
Provider Name | Amber Chewning |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204-3041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2017 |
Last Update Date | 20/10/2020 |