Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1161 | NC |
NPI | 1043450299 |
---|---|
Provider Name | Mrs. Julie Lavoie |
First Address | Charlotte, NC 28210-7297 |
Second Address | Charlotte, NC 28210-7297 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2009 |
Last Update Date | 01/03/2009 |