Provider Demographics
NPI:1629292818
Name:THAGARD, NANCY D (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:D
Last Name:THAGARD
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 1:308 BLOUNT ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2802
Mailing Address - Country:US
Mailing Address - Phone:910-596-4244
Mailing Address - Fax:910-596-4245
Practice Address - Street 1:405 BEAMAN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2909
Practice Address - Country:US
Practice Address - Phone:910-596-4244
Practice Address - Fax:910-596-4245
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1222225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist