Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 11412 | NC |
Y | 2251P0200X | Physical Therapist - Pediatrics | 11412 | NC |
NPI | 1003084906 |
---|---|
Provider Name | Ms. Megan Sean Hardisty |
First Address | Chapel Hill, NC 27214 |
Second Address | Raleigh, NC 27607-7511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 15/09/2008 |