Individual
MRS. JAN POWERS LAGUARDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1006 BROAD STREET, ORIENTAL, NC 28571
(252) 249-1051
(252) 249-0112
Mailing address
PO BOX 894, ORIENTAL, NC 28571-0894
(252) 249-1051
(252) 249-0112
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8706
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078JJ
BLUE CROSS BLUE SHIELD
NC
Enumeration date
11/15/2006
Last updated
06/29/2010
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