Doctor Name: | CHARLES COLE VICTOR VERTZ |
NPI Number: | 1942577929 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC, LAT |
License Number: | 1902 |
Business Practice Address: | 704-a College St Barton College Wilson, NC - 27893 |
Business Phone Number: | 2523996534 |
Business Fax Number: | 2523996516 |
Mailing Address: | 4913 Summit Place Dr Nw, #708 WILSON |
State: | NC |
Postal Code: | 278968171 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/19/2011 |
NPI Last Update Date: | 11/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1902 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |