Provider Demographics
NPI:1346691706
Name:HILL, MARY-ELLEN
Entity Type:Individual
Prefix:
First Name:MARY-ELLEN
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY-ELLEN
Other - Middle Name:
Other - Last Name:MAC PHAIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5343 EMERALDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-7170
Mailing Address - Country:US
Mailing Address - Phone:954-214-2101
Mailing Address - Fax:
Practice Address - Street 1:2002 BARTLETT CIR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-6921
Practice Address - Country:US
Practice Address - Phone:919-614-1923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14036225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist