Provider Demographics
NPI:1962984740
Name:PLEASANTS, MARY (DPT)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:PLEASANTS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:PLEASANTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:250 LOVERS LN
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3436
Mailing Address - Country:US
Mailing Address - Phone:252-975-1636
Mailing Address - Fax:
Practice Address - Street 1:250 LOVERS LN
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3436
Practice Address - Country:US
Practice Address - Phone:252-975-1636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13741225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist