| NPI | 1073143343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE WALLACE Owner 252-227-0251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 225100000X Physical Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2022-05-03 |