Provider Demographics
NPI:1760870653
Name:TURNER, ROGER (NC PTA #694)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:NC PTA #694
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 SAVANNAH VIEW LN
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-7235
Mailing Address - Country:US
Mailing Address - Phone:828-586-1508
Mailing Address - Fax:603-218-7676
Practice Address - Street 1:748 SAVANNAH VIEW LN
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-7235
Practice Address - Country:US
Practice Address - Phone:828-586-1508
Practice Address - Fax:603-218-7676
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-694172M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No172M00000XOther Service ProvidersMechanotherapist