Basic Information
Provider Information
NPI: 1063813186
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEGATIE
FirstName: ARIANA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2675 COURT DR
Address2:  
City: GASTONIA
State: NC
PostalCode: 280541478
CountryCode: US
TelephoneNumber: 7048247800
FaxNumber: 7048242822
Practice Location
Address1: 7427 MATTHEWS MINT HILL RD
Address2:  
City: MINT HILL
State: NC
PostalCode: 282277862
CountryCode: US
TelephoneNumber: 9087296525
FaxNumber: 9087296530
Other Information
ProviderEnumerationDate: 09/08/2014
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X871553DCN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X17241NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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