Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 4505 | NC |
N | 225700000X | Massage Therapist | 7359 | NC |
NPI | 1013203298 |
---|---|
Provider Name | Niya Spears |
First Address | Cary, NC 27518-7052 |
Second Address | Cary, NC 27518-7052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2011 |
Last Update Date | 21/03/2014 |