MEDICARE: GINGER S DILL P.T.

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	2251P0200X	Pediatric Physical Therapist	PT23636	CA
2	225100000X	Physical Therapist	23636	CA
3	2251P0200X	Pediatric Physical Therapist	11958	NC

General Provider Information

NPI Number	:	1548211253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINGER S DILL P.T.

Provider Business Mailing Address
First Line	:	7034 PITCAIRN DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-7512
Country	:	US
Telephone Number	:	760-845-9628
Fax Number	:

Provider Business Practice Location Address
First Line	:	4602 CUMBERLAND RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-2412
Country	:	US
Telephone Number	:	910-423-5622
Fax Number	:

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	02/02/2009

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