Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | P13769 | NC |
NPI | 1275055568 |
---|---|
Provider Name | Katie Lynn Sewell |
First Address | Wadesboro, NC 28170-2103 |
Second Address | Charlotte, NC 28203-5814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2017 |
Last Update Date | 09/07/2017 |