Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | P17576 | NC |
NPI | 1003321647 |
---|---|
Provider Name | Molly Rose Miller |
First Address | Chapel Hill, NC 27514-5827 |
Second Address | Chapel Hill, NC 27514-5827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2017 |
Last Update Date | 05/12/2017 |