Individual
MISS KARLY SUZANNE PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, EPC
Contact information
Practice address
170 KIMEL PARK DR, WINSTON SALEM, NC 27103-6946
(336) 765-7058
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2090
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P20473
NC
2251X0800X
Orthopedic Physical Therapist
10807
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730010
NSC #
NC
Enumeration date
08/30/2021
Last updated
12/17/2024
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