Fennimore, Gail Herndon
Fennimore, Gail Herndon is an individual health care provider with primary practice located at 4012 Park Rd Suite 200, Charlotte NC 28209-2377. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Fennimore, Gail Herndon can be contacted via phone (704) 332-4834.Contact Information
Primary practice address
4012 Park Rd Suite 200
Charlotte NC 28209-2377
Phone: (704) 332-4834
Fax: (704) 372-9653
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 1063 | North Carolina |
Profile Details
| NPI number | 1184684920 |
|---|---|
| LBN Legal business name | Fennimore, Gail Herndon |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Mar 7th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184684920 | NPPES |
| North Carolina | Other | 56-1480824 | FEDERAL TAX ID |
| North Carolina | MEDICAID | 7211539 | FEDERAL TAX ID |
| North Carolina | Other | 64-42619 | FEDERAL TAX ID |
| North Carolina | Other | 0103C | FEDERAL TAX ID |
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