Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | P15234 | NC |
NPI | 1659622066 |
---|---|
Provider Name | Dr. Amanda Mary Hyslop |
First Address | Charlotte, NC 28203-5814 |
Second Address | Charlotte, NC 28203-5814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2012 |
Last Update Date | 17/01/2017 |