Provider Demographics
NPI:1225573140
Name:PURSOO, WHITNEY (DPT)
Entity Type:Individual
Prefix:MISS
First Name:WHITNEY
Middle Name:
Last Name:PURSOO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:925 CROWDERS WOODS DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-5717
Mailing Address - Country:US
Mailing Address - Phone:205-872-8368
Mailing Address - Fax:
Practice Address - Street 1:425 WILCOX ST UNIT 653
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-4060
Practice Address - Country:US
Practice Address - Phone:205-872-8368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-01
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006825225100000X
NC16117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist