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General NPI Number Information
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NPI Number | 1447802459
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Entity Type | Individual
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Provider Name | MIRANDA NOVAK
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Gender | Female
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 226 CHARLOTTE HWY
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City | ASHEVILLE
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State | NC
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Zip | 28803-8628
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Country | US
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Telephone | 828-298-0492
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Fax |
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Provider Business Mailing Address
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Address Line | 2935 WATERCHASE WAY SW APT 205
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City | WYOMING
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State | MI
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Zip | 49519-5922
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Country | US
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Telephone | 262-442-7721
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501018696
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P20523
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License Number State | NC
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