Basic Information
| Provider Information | |||||||||
| NPI: | 1992757900 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABBEY | ||||||||
| FirstName: | ALKE | ||||||||
| MiddleName: | SOPHIE | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 EXECUTIVE PL | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283055390 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104235550 | ||||||||
| FaxNumber: | 9104235552 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 EXECUTIVE PL | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283055390 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104235550 | ||||||||
| FaxNumber: | 9104235552 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 03/06/2014 | ||||||||
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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 | 9169 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 07PYG | 01 | NC | BLUE CROSS BLUE SHIELD NC | OTHER | 125357800 | 01 | NC | TRICARE | OTHER | 125357800 | 01 | NC | US DEPART OF LABOR | OTHER | 185562 | 01 | NC | MEDCOST | OTHER |