Individual
JOYCE K MATONDANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
504 PERRAULT DR, MORRISVILLE, NC 27560-8633
(269) 753-2194
(919) 467-2148
Mailing address
504 PERRAULT DR, MORRISVILLE, NC 27560-8633
(269) 753-2194
(919) 467-2148
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11210
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069CN
BCBS
NC
01
—
DO0034
MEDICARE RAILROAD
NC
01
—
P00651353
MEDICARE RAILROAD
NC
Enumeration date
06/17/2008
Last updated
03/20/2009
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