Provider Demographics
NPI:1023560265
Name:GENTRY, CARMEN A (PT)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:A
Last Name:GENTRY
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 1:260 MERRIMON AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1244
Mailing Address - Country:US
Mailing Address - Phone:828-785-4700
Mailing Address - Fax:828-552-5566
Practice Address - Street 1:501 ESSEOLA DR
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:NC
Practice Address - Zip Code:28773-8821
Practice Address - Country:US
Practice Address - Phone:828-749-2261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP12915225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist