Basic Information
| Provider Information | |||||||||
| NPI: | 1831740034 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VAN VALKENBURG | ||||||||
| FirstName: | CLAIRE | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PT,DPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SCHNEIDER | ||||||||
| OtherFirstName: | CLAIRE | ||||||||
| OtherMiddleName: | LOUISE | ||||||||
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| OtherCredential: | PT,DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 775 HAYWOOD RD STE H | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288067111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287745222 | ||||||||
| FaxNumber: | 8287745254 | ||||||||
| Practice Location | |||||||||
| Address1: | 803 BERMUDA BAY BLVD | ||||||||
| Address2: | |||||||||
| City: | KILL DEVIL HILLS | ||||||||
| State: | NC | ||||||||
| PostalCode: | 279489537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525581243 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2019 | ||||||||
| LastUpdateDate: | 09/28/2019 | ||||||||
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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 | 2305002538 | VA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | P4032 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.