Michaela Bullins

Individual provider Active NPI Physical Therapy Assistant · Eden, NC

NPI 1154857951 · NPPES record last updated May 11, 2017

Key facts

NPI
1154857951
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
A6263 (NC)
Practice address
205 E Kings Hwy
Eden, NC 27288-5239
Phone
(336) 623-9712
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A6263NCMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A6263 NC Yes

Addresses

Primary practice location

205 E Kings Hwy
Eden, NC 27288-5239

Mailing address

205 E Kings Hwy
Eden, NC 27288-5239

Other providers in Eden, NC

All providers in Eden, NC · Physical Therapy Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.