Mary Richardson
Individual provider Active NPI Physical Therapy Assistant · Lowgap, NC
NPI 1588007132 · NPPES record last updated Apr 14, 2013
Key facts
- NPI
- 1588007132
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 4800 (NC)
- Practice address
- 211 Wood Ridge LN
Lowgap, NC 27024-8909 - Phone
- (336) 352-3419
- NPI assigned
- Apr 14, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4800 | NC | Yes |
Addresses
Primary practice location
211 Wood Ridge LN
Lowgap, NC 27024-8909
Mailing address
211 Wood Ridge LN
Lowgap, NC 27024-8909
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4800 | Other | NC | 225200000X |
Other providers in Lowgap, NC
All providers in Lowgap, NC · Physical Therapy Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.