Doctor Name: | MS. AUTUMN LYNN ABRAHAM |
NPI Number: | 1003237322 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | P14595 |
Business Practice Address: | 1517 N Howe St Suite 4 Southport, NC - 284612772 |
Business Phone Number: | 9104540064 |
Business Fax Number: | |
Mailing Address: | 229 Lullwater Dr, WILMINGTON |
State: | NC |
Postal Code: | 284031527 |
Phone Number: | 8594686435 |
Fax Number: | |
NPI Enumeration Date: | 01/05/2014 |
NPI Last Update Date: | 01/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | P14595 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |