Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | P19324 | NC |
NPI | 1093349789 |
---|---|
Provider Name | Dr. Alexis Niani Mccrea |
First Address | Danville, VA 24540-2863 |
Second Address | Danville, VA 24540-2863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2020 |
Last Update Date | 16/07/2020 |