MEDICARE: MRS. HAZEL ALICE E PRACHT 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	7475	NC

General Provider Information

NPI Number	:	1487816138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HAZEL ALICE E PRACHT PT

Provider Business Mailing Address
First Line	:	316 AUSTIN VIEW BLVD
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-1809
Country	:	US
Telephone Number	:	919-809-2881
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 AUSTIN VIEW BLVD
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-1809
Country	:	US
Telephone Number	:	919-809-2881
Fax Number	:

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

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	02/02/2026

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