Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | P5056 | NC |
NPI | 1003206632 |
---|---|
Provider Name | Jana Delengowski |
First Address | Cary, NC 27518-8100 |
Second Address | Cary, NC 27518-8100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2015 |
Last Update Date | 03/02/2015 |