Provider Demographics
NPI:1104031855
Name:MCCOY, SALLY J (LPT)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:J
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5434 STATE HIGHWAY 197 S
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-7621
Mailing Address - Country:US
Mailing Address - Phone:828-682-6979
Mailing Address - Fax:828-254-8887
Practice Address - Street 1:143 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1815
Practice Address - Country:US
Practice Address - Phone:828-254-8889
Practice Address - Fax:828-254-8887
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13432251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics