Healthcare Provider Details

I. General information

NPI: 1467953059
Provider Name (Legal Business Name): CASSANDRA MCGUIRK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2018
Last Update Date: 02/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 HILLANDALE RD STE 25B
DURHAM NC
27705-2671
US

IV. Provider business mailing address

1821 HILLANDALE RD STE 25B
DURHAM NC
27705-2671
US

V. Phone/Fax

Practice location:
  • Phone: 919-660-6748
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License NumberP14429
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: