Provider Demographics
NPI:1396850038
Name:KRAMER, THERESA HALLEMEYER (PT)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:HALLEMEYER
Last Name:KRAMER
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 1:2002 EASTWOOD RD STE 301
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-7203
Mailing Address - Country:US
Mailing Address - Phone:910-256-4442
Mailing Address - Fax:910-256-4443
Practice Address - Street 1:2002 EASTWOOD RD STE 301
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7203
Practice Address - Country:US
Practice Address - Phone:910-256-4442
Practice Address - Fax:910-256-4443
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3815225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2503889AMedicare ID - Type Unspecified