Provider Demographics
NPI:1942332432
Name:CYPHER, CAREY (PT)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:
Last Name:CYPHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 BEXLEY DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2001
Mailing Address - Country:US
Mailing Address - Phone:910-392-4512
Mailing Address - Fax:910-793-1050
Practice Address - Street 1:1413 BEXLEY DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2001
Practice Address - Country:US
Practice Address - Phone:910-392-4512
Practice Address - Fax:910-793-1050
Is Sole Proprietor?:No
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0786JOtherBCBSNC PROVIDER ID