Basic Information
| Provider Information | |||||||||
| NPI: | 1467886309 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MENDOZA | ||||||||
| FirstName: | ESMERALDA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT, LAT, ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1801 OLIVE CHAPEL RD | ||||||||
| Address2: | STE 103 | ||||||||
| City: | APEX | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275025709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9195358758 | ||||||||
| FaxNumber: | 9195353271 | ||||||||
| Practice Location | |||||||||
| Address1: | 2140 W ARLINGTON BLVD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278345709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525654950 | ||||||||
| FaxNumber: | 2523783038 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2013 | ||||||||
| LastUpdateDate: | 08/15/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT 28506 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.