Individual
ELIZABETH ANN BEVELACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4201 LAKE BOONE TRAIL, SUITE 4, RALEIGH, NC 27607-7511
(919) 781-4434
(919) 781-5851
Mailing address
4201 LAKE BOONE TRAIL, SUITE 4, RALEIGH, NC 27607-7511
(919) 781-4434
(919) 781-5851
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4875
NC
225100000X
Physical Therapist
Primary
P4875
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
720789U
—
NC
Enumeration date
01/12/2007
Last updated
05/01/2026
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