Provider Demographics
NPI:1700479789
Name:GUNTHNER, ANTOINETTE (PT)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:GUNTHNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6005 SENTINEL DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-3417
Mailing Address - Country:US
Mailing Address - Phone:704-241-1890
Mailing Address - Fax:
Practice Address - Street 1:2101 RUNNYMEDE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3316
Practice Address - Country:US
Practice Address - Phone:704-525-5508
Practice Address - Fax:704-527-7027
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9023225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist