Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 11628 | NC |
NPI | 1043596950 |
---|---|
Provider Name | Matthew Wilkinson |
First Address | Cary, NC 27513-3510 |
Second Address | Cary, NC 27513-3510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2011 |
Last Update Date | 25/10/2011 |