Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | P16519 | NC |
NPI | 1336599844 |
---|---|
Provider Name | Clara Backus |
First Address | Chapel Hill, NC 27517-7222 |
Second Address | Chapel Hill, NC 27517-7222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2016 |
Last Update Date | 05/01/2022 |