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NPI Code Detail

MEDICARE: MRS. MARGARET M VERMILLION MSPT

MEDICARE: MRS. MARGARET M VERMILLION MSPT
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 TherapistPT9498NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11295160257OTHERNCNPI

General Provider Information

NPI Number : 1073947669
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARGARET M VERMILLION MSPT
Provider Business Mailing Address
First Line : 19423 SCHOONER DR
Second Line :
City : CORNELIUS
State : NC
Zip : 28031-5854
Country : US
Telephone Number : 704-293-3663
Fax Number :
Provider Business Practice Location Address
First Line : 18831 STATESVILLE RD
Second Line :
City : CORNELIUS
State : NC
Zip : 28031-6755
Country : US
Telephone Number : 704-293-3663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2013
Last Update Date : 10/21/2013

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