Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT25491 | FL |
NPI | 1003078957 |
---|---|
Provider Name | Lee Spilman |
First Address | Windermere, FL 34786-6098 |
Second Address | Cary, NC 27513-8431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2008 |
Last Update Date | 22/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
150FV | BCBS OF NC (01) | NC |
2504213 | (02) | NC |