Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 8626 | NC |
NPI | 1013471903 |
---|---|
Provider Name | Julie Gillespie |
First Address | Asheville, NC 28803-3496 |
Second Address | Asheville, NC 28803-3496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2019 |
Last Update Date | 25/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8626 | (05) | NC |
8626 | PRIVATE HEALTH INSURANCE (01) | NC |