Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1343 | NC |
NPI | 1104031855 |
---|---|
Provider Name | Ms. Sally J Mccoy |
First Address | Burnsville, NC 28714-7621 |
Second Address | Asheville, NC 28801-1815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |