MEDICARE: MARY CHRISTINE JOY ALOJIPAN BUSIL PT

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
1	225100000X	Physical Therapist	11925	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	YPPW14779089	OTHER		BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1134453533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY CHRISTINE JOY ALOJIPAN BUSIL PT

Provider Business Mailing Address
First Line	:	4414 JOHN PENN CIR
Second Line	:	APARTMENT I
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-1765
Country	:	US
Telephone Number	:	910-622-7795
Fax Number	:

Provider Business Practice Location Address
First Line	:	4414 JOHN PENN CIR
Second Line	:	APARTMENT I
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-1765
Country	:	US
Telephone Number	:	910-622-7795
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2009
Last Update Date	:	10/01/2009

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