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NPI Code Detail

MEDICARE: GREGORY C MUSGNUG DPT

MEDICARE:   GREGORY C MUSGNUG  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistP19057NC

General Provider Information

NPI Number : 1003461435
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY C MUSGNUG DPT
Provider Business Mailing Address
First Line : 1300 BRIDGE BARRIER RD STE 3
Second Line :
City : CAROLINA BEACH
State : NC
Zip : 28428-3939
Country : US
Telephone Number : 910-636-3574
Fax Number :
Provider Business Practice Location Address
First Line : 1300 BRIDGE BARRIER RD STE 3
Second Line :
City : CAROLINA BEACH
State : NC
Zip : 28428-3939
Country : US
Telephone Number : 910-636-3574
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2019
Last Update Date : 01/25/2020

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Directions to “ GREGORY C MUSGNUG DPT” Practice Location

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