Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | P12891 | NC |
NPI | 1003116377 |
---|---|
Provider Name | Alicia Mcquain |
First Address | Chapel Hill, NC 27516-4083 |
Second Address | Gastonia, NC 28054-2176 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2010 |
Last Update Date | 02/11/2010 |