Provider Demographics
NPI:1043659675
Name:WERNER, DEVON JANELL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:JANELL
Last Name:WERNER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 WILLOW BROOK CT
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-8358
Mailing Address - Country:US
Mailing Address - Phone:856-905-9797
Mailing Address - Fax:
Practice Address - Street 1:4104 SURLES CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8238
Practice Address - Country:US
Practice Address - Phone:919-941-1911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist