Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | P5547 | NC |
NPI | 1013317015 |
---|---|
Provider Name | Mrs. Tamara J Heath |
First Address | Charlotte, NC 28226-7519 |
Second Address | Charlotte, NC 28226-7519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2014 |
Last Update Date | 26/08/2014 |