Provider Demographics
NPI:1154087146
Name:VETRONE, CHRIS PAUL (PTA)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:PAUL
Last Name:VETRONE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6007 EMBASSY CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-8071
Mailing Address - Country:US
Mailing Address - Phone:336-988-4516
Mailing Address - Fax:
Practice Address - Street 1:3600 PARK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-4102
Practice Address - Country:US
Practice Address - Phone:704-709-5004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-13
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty