Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | P14963 | NC |
N | 2251N0400X | Physical Therapist - Neurology | 037530 | NY |
N | 2251N0400X | Physical Therapist - Neurology | P14963 | NC |
N | 2251N0400X | Physical Therapist - Neurology | PT023534 | PA |
NPI | 1184018574 |
---|---|
Provider Name | Chia-Cheng Lin |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-8982 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2015 |
Last Update Date | 25/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1184018574 | (05) | NC |
19B7J | BCBSNC (01) | NC |