Provider Demographics
NPI:1538687181
Name:STERNER, CHARLES SANFORD (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:SANFORD
Last Name:STERNER
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 GASTON DAY SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-7514
Mailing Address - Country:US
Mailing Address - Phone:336-407-5633
Mailing Address - Fax:
Practice Address - Street 1:2001 GASTON DAY SCHOOL RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-7514
Practice Address - Country:US
Practice Address - Phone:336-407-5633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-05
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
NCLAT-43902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC103337696OtherDRIVERS LICENSE