Provider Demographics
NPI:1710005210
Name:WADSWORTH, JOHN B (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:B
Last Name:WADSWORTH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 943
Mailing Address - Street 2:209 NORTH MITCHELL
Mailing Address - City:BAKERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28705-0943
Mailing Address - Country:US
Mailing Address - Phone:828-284-0103
Mailing Address - Fax:828-766-3065
Practice Address - Street 1:125 HOSPITAL DR
Practice Address - Street 2:SPRUCE PINE HOSPITAL
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-3035
Practice Address - Country:US
Practice Address - Phone:828-765-7901
Practice Address - Fax:828-766-3065
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC8457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist