Provider Demographics
NPI:1285669788
Name:VENTRE, ELIZABETH ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:VENTRE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 S 39TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6201
Mailing Address - Country:US
Mailing Address - Phone:910-793-6506
Mailing Address - Fax:910-313-6711
Practice Address - Street 1:4706 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-392-3770
Practice Address - Fax:910-313-6711
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6378225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2335979Medicare ID - Type Unspecified