Provider Demographics
NPI:1083825442
Name:MACARILAY, BESSIE PACHECO (PT)
Entity Type:Individual
Prefix:MRS
First Name:BESSIE
Middle Name:PACHECO
Last Name:MACARILAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 CLYDE CIR
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-8737
Mailing Address - Country:US
Mailing Address - Phone:910-738-1013
Mailing Address - Fax:
Practice Address - Street 1:300 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-1119
Practice Address - Country:US
Practice Address - Phone:910-618-9807
Practice Address - Fax:910-618-9216
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist