Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | P11720 | NC |
NPI | 1003251190 |
---|---|
Provider Name | Kathleen M Cameron |
First Address | Kinston, NC 28504-1969 |
Second Address | Kinston, NC 28504-1969 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2013 |
Last Update Date | 03/05/2013 |