Individual
MS. MICHELLE MARIE MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1491
SD
225100000X
Physical Therapist
6215
MN
225100000X
Physical Therapist
8775
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078TN
BCBS
NC
Enumeration date
04/27/2006
Last updated
05/10/2016
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