Provider Demographics
NPI:1952672313
Name:NELLAS, ABIGAIL (PT)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:
Last Name:NELLAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:ABIGAIL
Other - Middle Name:NELLAS
Other - Last Name:PLACINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:620 HEATHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-8604
Mailing Address - Country:US
Mailing Address - Phone:704-983-6890
Mailing Address - Fax:
Practice Address - Street 1:620 HEATHWOOD DR
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-8604
Practice Address - Country:US
Practice Address - Phone:704-983-6890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP10843225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist