Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | A7366 | NC |
N | 2251G0304X | Physical Therapist - Geriatrics | A7366 | NC |
NPI | 1154999506 |
---|---|
Provider Name | Esteban Lee Garay |
First Address | Matthews, NC 28105-4693 |
Second Address | Mint Hill, NC 28227-7078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2021 |
Last Update Date | 15/06/2021 |