Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | P12468 | NC |
NPI | 1194131086 |
---|---|
Provider Name | Kathleen Villar |
First Address | Cary, NC 27519-6464 |
Second Address | Cary, NC 27519-6464 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2014 |
Last Update Date | 11/07/2014 |