Basic Information
| Provider Information | |||||||||
| NPI: | 1700479789 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUNTHNER | ||||||||
| FirstName: | ANTOINETTE | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6005 SENTINEL DR | ||||||||
| Address2: | |||||||||
| City: | INDIAN TRAIL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280793417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042411890 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2101 RUNNYMEDE LN | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282093316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7045255508 | ||||||||
| FaxNumber: | 7045277027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2021 | ||||||||
| LastUpdateDate: | 02/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 9023 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.