Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251X0800X | Physical Therapist - Orthopedic | 29264 | FL |
Y | 2251X0800X | Physical Therapist - Orthopedic | P15982 | NC |
NPI | 1003228081 |
---|---|
Provider Name | Courtney Fletcher |
First Address | Raleigh, NC 27615-4730 |
Second Address | Raleigh, NC 27615-4730 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2014 |
Last Update Date | 15/02/2016 |