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1104078856
DARREN EUGENE PRIDE
GASTONIA, NC
NPI
1104078856
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: VA 2306602552)
Enumeration Date
2008-10-14
Last Update Date
2008-10-14
Business Address
-- DARREN EUGENE PRIDE PTA
801 COX RD
GASTONIA, NC 28054-3453
Phone number: 704-867-7455
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Mailing Address
-- DARREN EUGENE PRIDE PTA
15705 COLONY OAKS DR APT 522
CHARLOTTE, NC 28277-3005
Phone number: 410-963-8960
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