Provider Demographics
NPI:1780718627
Name:HESSELTINE, MANDY CAY (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MISS
First Name:MANDY
Middle Name:CAY
Last Name:HESSELTINE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:866-518-0283
Mailing Address - Fax:
Practice Address - Street 1:16139 LANCASTER HWY STE 140
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2976
Practice Address - Country:US
Practice Address - Phone:704-542-2492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCP031303T225100000X
MSCP030292T225100000X
ALCP043874T225100000X
GACP026791T225100000X
TX1173443225100000X
VACP031303T225100000X
SCCP030102T225100000X
NCCP030101T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196787901Medicaid
TX8T8157OtherBCBS
TX8T8157OtherBCBS