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Individual

DANA BROUGHTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
511 ALDEN BRIDGE DR, CARY, NC 27519-8396
(984) 255-4105
Mailing address
511 ALDEN BRIDGE DR, CARY, NC 27519-8396
(984) 255-4105

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P7612
NC
2251P0200X
Pediatric Physical Therapist
P7612
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P7612
NORTH CAROLINA BOARD OF PHYSICAL THERAPY
NC
Enumeration date
10/02/2006
Last updated
08/23/2016
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