Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | P14928 | NC |
NPI | 1285041749 |
---|---|
Provider Name | Tyler Hassinger |
First Address | Holly Springs, NC 27540-3378 |
Second Address | Lillington, NC 27546-9633 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2014 |
Last Update Date | 16/07/2014 |