Individual
MISS STACEY MCCRARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
197 PIEDMONT BLVD STE 111, ROCK HILL, SC 29732-1825
(803) 909-6447
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2090
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10453
SC
225100000X
Physical Therapist
P19840
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730048
NSC #
SC
Enumeration date
11/06/2020
Last updated
03/24/2021
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