Provider Demographics
NPI:1952008286
Name:COLE, JOHN CHRIS (CEP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRIS
Last Name:COLE
Suffix:
Gender:M
Credentials:CEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 WISE FIVE FORKS RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27589-9529
Mailing Address - Country:US
Mailing Address - Phone:423-512-2648
Mailing Address - Fax:
Practice Address - Street 1:511 RUIN CREEK RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5919
Practice Address - Country:US
Practice Address - Phone:252-436-6395
Practice Address - Fax:252-436-1472
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1053508224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist