Provider Demographics
NPI:1316314628
Name:CARELS, WENDY BALLARD (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:BALLARD
Last Name:CARELS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636A BROOK HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-8590
Mailing Address - Country:US
Mailing Address - Phone:419-494-7278
Mailing Address - Fax:
Practice Address - Street 1:130 DUKE RD
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-9584
Practice Address - Country:US
Practice Address - Phone:419-494-7278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP6754225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist