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General NPI Number Information
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NPI Number | 1336599844
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Entity Type | Individual
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Provider Name | CLARA LOUISE MARTIN BACKUS
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Gender | Female
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 11312 US 15 501 N STE 403
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City | CHAPEL HILL
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State | NC
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Zip | 27517
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Country | US
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Telephone | 919-619-2461
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Fax |
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Provider Business Mailing Address
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Address Line | 904 TALLYHO TRL
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City | CHAPEL HILL
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State | NC
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Zip | 27516-9018
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Country | US
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Telephone | 919-619-2461
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | P16519
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License Number State | NC
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