Provider Demographics
NPI:1609337526
Name:CLYMER, ABIGAIL MICHELLE (DPT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MICHELLE
Last Name:CLYMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:M
Other - Last Name:JEFFRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1991 FORDHAM DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3774
Mailing Address - Country:US
Mailing Address - Phone:910-484-4653
Mailing Address - Fax:
Practice Address - Street 1:1991 FORDHAM DR STE 100
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3774
Practice Address - Country:US
Practice Address - Phone:910-484-4653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP18211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist