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General NPI Number Information
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NPI Number | 1982033056
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Entity Type | Individual
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Provider Name | CAITRIONA O'SHAUGHNESSY PT/PEDS
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Gender | Female
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 2675 COURT DR
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City | GASTONIA
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State | NC
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Zip | 28054-1478
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Country | US
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Telephone | 704-824-7800
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Fax | 704-824-2853
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Provider Business Mailing Address
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Address Line | 1027 FALLS CREEK LN APT 14
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City | CHARLOTTE
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State | NC
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Zip | 28209-4772
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Country | US
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Telephone | 704-915-8493
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Fax | 704-824-3999
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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 | 14560
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License Number State | NC
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