Individual
DR. JOSCELYN CELESTE SHUMATE BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, CSCS
Contact information
Practice address
5960 FAIRVIEW RD STE 250, CHARLOTTE, NC 28210-0199
(980) 224-7958
(980) 224-7973
Mailing address
1377 MOTOR PKWY STE 307, ISLANDIA, NY 11749-5258
(631) 580-5200
(631) 580-5222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
039719-1
NY
225100000X
Physical Therapist
8797
SC
225100000X
Physical Therapist
Primary
P18386
NC
2251S0007X
Sports Physical Therapist
039719-1
NY
2251X0800X
Orthopedic Physical Therapist
039719-1
NY
Other
Enumeration date
01/18/2016
Last updated
03/01/2020
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