Provider Demographics
NPI:1831450758
Name:WOLFE, DARBY MARIE (LPTA)
Entity type:Individual
Prefix:MRS
First Name:DARBY
Middle Name:MARIE
Last Name:WOLFE
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 1:257 ROYALTON RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-6778
Mailing Address - Country:US
Mailing Address - Phone:704-818-7825
Mailing Address - Fax:
Practice Address - Street 1:1810 CONCORD LAKE RD
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-6434
Practice Address - Country:US
Practice Address - Phone:704-933-3781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA4593225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant