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Individual

TRAE MINGUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8918 BLAKENEY PROFESSIONAL DR STE 120, CHARLOTTE, NC 28277-6692
(704) 900-8960
Mailing address
1013 HIDEAWAY LN APT 100, FORT MILL, SC 29707-6085

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
P19646
NC
2255A2300X
Athletic Trainer

Other

Enumeration date
05/20/2016
Last updated
07/19/2022
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