Provider Demographics
NPI:1356536205
Name:PHELPS, JOYCE EQUILS (LPTA)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:EQUILS
Last Name:PHELPS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 LAMB RD
Mailing Address - Street 2:
Mailing Address - City:ROPER
Mailing Address - State:NC
Mailing Address - Zip Code:27970-9672
Mailing Address - Country:US
Mailing Address - Phone:252-793-6422
Mailing Address - Fax:
Practice Address - Street 1:1485 INTERNATIONAL PKWY STE 2051
Practice Address - Street 2:
Practice Address - City:HEATHROW
Practice Address - State:FL
Practice Address - Zip Code:32746-5352
Practice Address - Country:US
Practice Address - Phone:800-798-6035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC487225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant