Provider Demographics
NPI:1902090673
Name:ZACHARKO, NOAH T (PT,DPT,MPT)
Entity Type:Individual
Prefix:MR
First Name:NOAH
Middle Name:T
Last Name:ZACHARKO
Suffix:
Gender:M
Credentials:PT,DPT,MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 PARK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3239
Mailing Address - Country:US
Mailing Address - Phone:704-323-2000
Mailing Address - Fax:
Practice Address - Street 1:710 PARK CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5012
Practice Address - Country:US
Practice Address - Phone:704-323-3208
Practice Address - Fax:704-323-3240
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1030802251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic