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Organization
MY PT LLC
Active
Organization
MY PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIRGININA G LANIER PT, DPT (OWNER, PHYSICAL THERAPIST)
(919) 260-6912
Entity
Organization
Contact information
Practice address
112 QUAILVIEW DR, CHAPEL HILL, NC 27516-9337
(919) 260-6912
Mailing address
112 QUAILVIEW DR, CHAPEL HILL, NC 27516-9337
(919) 260-6912
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P14170
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841595881
NPI
—
01
—
P14170
PT LICENSE
NC
Enumeration date
05/11/2017
Last updated
05/11/2017
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