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General NPI Number Information
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NPI Number | 1306653183
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Entity Type | Individual
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Provider Name | CAROLINE MARGARET PHILBECK OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 111 KILSON DR STE 104
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City | MOORESVILLE
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State | NC
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Zip | 28117-8218
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Country | US
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Telephone | 980-317-0985
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Fax |
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Provider Business Mailing Address
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Address Line | 515 BLACKSNAKE RD
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City | STANLEY
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State | NC
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Zip | 28164-1627
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Country | US
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Telephone | 704-477-4496
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 17368
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License Number State | NC
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