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General NPI Number Information
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NPI Number | 1942690839
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Entity Type | Individual
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Provider Name | CHRISTINA DYCK P.T.A.
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Gender | Female
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 3001 SPRING FOREST RD
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City | RALEIGH
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State | NC
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Zip | 27616-2815
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Country | US
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Telephone | 386-447-4114
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Fax |
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Provider Business Mailing Address
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Address Line | 2515 OXBOROUGH DR
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City | MATTHEWS
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State | NC
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Zip | 28105-8849
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Country | US
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Telephone | 704-620-2473
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | A5180
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License Number State | NC
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