Provider Demographics
NPI:1598288631
Name:BINGHAM, CLAIRE ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ELIZABETH
Last Name:BINGHAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:ELIZABETH
Other - Last Name:GOODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4601 PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2290
Mailing Address - Country:US
Mailing Address - Phone:704-323-2237
Mailing Address - Fax:704-945-7681
Practice Address - Street 1:214 18TH ST SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1363
Practice Address - Country:US
Practice Address - Phone:828-485-2160
Practice Address - Fax:828-485-2161
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist