Provider Demographics
NPI:1457528523
Name:HAMPTON, MARY ANN (LPT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANN
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1482 BUMGARNER JAMES LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-7488
Mailing Address - Country:US
Mailing Address - Phone:704-732-0974
Mailing Address - Fax:
Practice Address - Street 1:1482 BUMGARNER JAMES LN
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-7488
Practice Address - Country:US
Practice Address - Phone:704-732-0974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist