Provider Demographics
NPI:1043803992
Name:WOELKERS, CHARLETTE MICHELLE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CHARLETTE
Middle Name:MICHELLE
Last Name:WOELKERS
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 1:739 BLACK SWEEP RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2358
Mailing Address - Country:US
Mailing Address - Phone:570-903-4763
Mailing Address - Fax:
Practice Address - Street 1:9161 LIBERIA AVE STE 205
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-1723
Practice Address - Country:US
Practice Address - Phone:571-229-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214137225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist