Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 8434 | NC |
N | 2251G0304X | Physical Therapist - Geriatrics | 8434 | NC |
NPI | 1265837215 |
---|---|
Provider Name | Dhruti Vakil |
First Address | Concord, NC 28027-8019 |
Second Address | Concord, NC 28027-8019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2014 |
Last Update Date | 01/11/2014 |