Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | P12872 | NC |
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1023304698 |
---|---|
Provider Name | Sarah Thompson Ihnat |
First Address | Leland, NC 28451-4217 |
Second Address | Leland, NC 28451-4217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2011 |
Last Update Date | 23/03/2017 |