Provider Demographics
NPI:1417078973
Name:ELMORE, ANN MARIE (P T, I-TFS)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:ELMORE
Suffix:
Gender:F
Credentials:P T, I-TFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7829 PERCUSSION DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-3611
Mailing Address - Country:US
Mailing Address - Phone:919-363-7545
Mailing Address - Fax:919-363-7545
Practice Address - Street 1:7829 PERCUSSION DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-3611
Practice Address - Country:US
Practice Address - Phone:919-363-7545
Practice Address - Fax:919-363-7545
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3360225100000X
NC252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist