Individual
MICHAEL L COLEGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
9101 ASHTON BROOK DR, KERNERSVILLE, NC 27284-8467
(336) 971-3000
Mailing address
9101 ASHTON BROOK DR, KERNERSVILLE, NC 27284-8467
(336) 971-3000
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
P4627
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P4627
PHYSICAL THERAPY
NC
Enumeration date
06/14/2012
Last updated
07/07/2022
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