| NPI | 1083573620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD SCOTT NICKLAS Physical Therapist 336-769-6162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2026-01-20 |
| Last Update Date | 2026-01-20 |