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General NPI Number Information
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NPI Number | 1770495509
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Entity Type | Individual
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Provider Name | SUNNY MAYALL PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 6048 W HIGHWAY 74
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-3591
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Country | US
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Telephone | 980-993-5540
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Fax |
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Provider Business Mailing Address
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Address Line | 2630 SOUTH BLVD APT 133
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City | CHARLOTTE
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State | NC
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Zip | 28209-1175
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Country | US
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Telephone | 803-260-5449
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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 | P25272
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License Number State | NC
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