Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | P9949 | NC |
NPI | 1003273681 |
---|---|
Provider Name | Rita M. Kotsias |
First Address | Asheville, NC 28813-0294 |
Second Address | Hendersonville, NC 28791-3540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2016 |
Last Update Date | 15/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19H20 | BCBS OF NC (01) | NC |
Q52791A | MEDICARE PTAN (01) |