Provider Demographics
NPI:1245530005
Name:STORY, ZACH A (OTR/L, NSCA-CPT)
Entity type:Individual
Prefix:
First Name:ZACH
Middle Name:A
Last Name:STORY
Suffix:
Gender:M
Credentials:OTR/L, NSCA-CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WALSHINGHAM LN
Mailing Address - Street 2:APARTMENT LB
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5263
Mailing Address - Country:US
Mailing Address - Phone:310-866-3850
Mailing Address - Fax:
Practice Address - Street 1:779 WOODY DR
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-3812
Practice Address - Country:US
Practice Address - Phone:336-228-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7698225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology