Provider Demographics
NPI:1164610424
Name:NEWPORT, LINDA J (LPTA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:NEWPORT
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 COBBLEPOINT WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8250
Mailing Address - Country:US
Mailing Address - Phone:919-795-1793
Mailing Address - Fax:
Practice Address - Street 1:3000 GALLOWAY RDG
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-8639
Practice Address - Country:US
Practice Address - Phone:919-545-2215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3370225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant