Individual
AMY C O'REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
111 CENTRAL PARK AVE, SUITE E, PINEHURST, NC 28374-8726
(910) 215-0541
(910) 215-9886
Mailing address
111 CENTRAL PARK AVE, SUITE E, PINEHURST, NC 28374-8726
(910) 215-0541
(910) 215-9886
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7583
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2334264
MEDICARE GROUP PTAN
NC
01
—
2506015
MEDICARE INDIVIDUAL PTAN
NC
Enumeration date
08/19/2009
Last updated
09/29/2009
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