Provider Demographics
NPI:1316121999
Name:PIECUCH, JANEA SWEET (DPT)
Entity type:Individual
Prefix:
First Name:JANEA
Middle Name:SWEET
Last Name:PIECUCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 HILDA GRACE LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8757
Mailing Address - Country:US
Mailing Address - Phone:803-467-5787
Mailing Address - Fax:803-467-5787
Practice Address - Street 1:3700 NW CARY PKWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8446
Practice Address - Country:US
Practice Address - Phone:803-467-5787
Practice Address - Fax:803-467-5787
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI02684225100000X
MA19340225100000X
NCP11173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist