Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 2305202325 | VA |
NPI | 1497961668 |
---|---|
Provider Name | Brian Mcguire |
First Address | Charlottesville, VA 22901-8953 |
Second Address | Charlottesville, VA 22904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |