Mary Tracey Alyson Kavanaugh | Huntersville, NC • PECOS Search

Mary Tracey Alyson Kavanaugh

Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

14330 Oakhill Park Ln Ste 115, Huntersville, NC 28078-3479

(704) 316-1280 (704) 316-1266

PECOS Enrollment

Based on the most recent information from CMS, provider Mary Tracey Alyson Kavanaugh does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:51 AM.

Profile Details

Provider ID
1558688010
Provider Type
Individual
Full Name
Kavanaugh, Mary Tracey Alyson
Credential
PT

Gender
Female
Sole Proprietor
No
Enumeration Date
4/23/2010
Last Updated
2/12/2024

Contact Information

Practice Location

14330 Oakhill Park Ln Ste 115, Huntersville, NC 28078-3479

(704) 316-1266

Mailing Location

PO Box 601791, Charlotte, NC 28260-1791

(704) 316-1266

Provider Taxonomies

Code	Description	License
Code 225100000X Primary	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License P9204 North Carolina