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NPI Code Detail

MEDICARE: CAROLYN ELISE POCKAT MCKINNEY DPT

MEDICARE: CAROLYN ELISE POCKAT MCKINNEY 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 TherapistP12662NC

General Provider Information

NPI Number : 1205147220
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN ELISE POCKAT MCKINNEY DPT
Provider Business Mailing Address
First Line : 414 SEASTONE ST
Second Line :
City : RALEIGH
State : NC
Zip : 27603-3191
Country : US
Telephone Number : 704-779-4216
Fax Number :
Provider Business Practice Location Address
First Line : 7532 WILKINS DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28311-9338
Country : US
Telephone Number : 910-868-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2010
Last Update Date : 01/12/2026

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