Provider Demographics
NPI:1780239079
Name:GAITHER, ANTHONY CURTIS (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CURTIS
Last Name:GAITHER
Suffix:
Gender:M
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 1:224 SKYVIEW LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HARMONY
Mailing Address - State:NC
Mailing Address - Zip Code:28634-9036
Mailing Address - Country:US
Mailing Address - Phone:704-880-7522
Mailing Address - Fax:
Practice Address - Street 1:400 JOHNSON RIDGE MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2447
Practice Address - Country:US
Practice Address - Phone:336-526-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14723225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist