Individual
JOAN ROAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
137 W MAIN ST, JEFFERSON, NC 28640-0331
(336) 246-3554
(336) 246-4547
Mailing address
PO BOX 331, 137 WEST MAIN STREET, JEFFERSON, NC 28640-0331
(336) 246-3554
(336) 246-4547
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
NC1067
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07811
BCBS
NC
01
—
4282130
QUAL CHOICE
NC
05
—
7200032
—
NC
Enumeration date
11/20/2006
Last updated
03/19/2012
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