Individual
KAREN A BACKALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
111 CENTRAL PARK AVE STE E, PINEHURST, NC 28374-8805
(910) 215-0541
(910) 215-9886
Mailing address
112 N RIVER RD, BRIDGEWATER, VA 22812-1611
(540) 828-6443
(540) 828-6583
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2199
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0775N
ANTHEM PROVIDER NUMBER
NC
Enumeration date
10/17/2005
Last updated
10/31/2007
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