Individual
MICHAEL A JENKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
2034 RANDOLPH RD, CHARLOTTE, NC 28207-1216
(704) 377-7099
(704) 377-7983
Mailing address
2034 RANDOLPH RD, CHARLOTTE, NC 28207-1216
(704) 377-7099
(704) 377-7983
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7703499
—
NC
05
—
7795013
—
NC
Enumeration date
03/30/2007
Last updated
09/11/2025
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