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NPI Code Detail

MEDICARE: MR. STEPHEN ROBERT CAVITT PHYSICAL THERAPIST

MEDICARE: MR. STEPHEN ROBERT CAVITT PHYSICAL THERAPIST
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 Therapist9947NC
2225100000XPhysical Therapist1129138TX

General Provider Information

NPI Number : 1194982199
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN ROBERT CAVITT PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 616 WADE AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27605-1237
Country : US
Telephone Number : 919-828-6251
Fax Number :
Provider Business Practice Location Address
First Line : 616 WADE AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27605-1237
Country : US
Telephone Number : 919-828-6251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2008
Last Update Date : 05/19/2008

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