Individual
JOHNATHON LEE CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
10000 CAMBRIDGE VILLAGE LOOP, APEX, NC 27502-7707
(919) 350-1508
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(877) 498-4490
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12130
NC
Other
Enumeration date
09/05/2024
Last updated
09/10/2024
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