Provider Demographics
NPI:1235334699
Name:VANG, ELAINE HANG (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:HANG
Last Name:VANG
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5994 US HIGHWAY 220 S
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-1572
Mailing Address - Country:US
Mailing Address - Phone:336-460-2891
Mailing Address - Fax:
Practice Address - Street 1:230 E PRESNELL ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4743
Practice Address - Country:US
Practice Address - Phone:336-629-1447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2636225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant