Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 6303 | NC |
NPI | 1295006757 |
---|---|
Provider Name | Ms. Iwona Maria Matthews |
First Address | Cary, NC 27518-7052 |
Second Address | Cary, NC 27518-7052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2012 |
Last Update Date | 14/01/2012 |