Provider Demographics
NPI:1073947669
Name:VERMILLION, MARGARET M (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:M
Last Name:VERMILLION
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19423 SCHOONER DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5854
Mailing Address - Country:US
Mailing Address - Phone:704-293-3663
Mailing Address - Fax:
Practice Address - Street 1:18831 STATESVILLE RD
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6755
Practice Address - Country:US
Practice Address - Phone:704-293-3663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-30
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPT9498225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1295160257OtherNPI