| NPI | 1104989458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA DENNIE MCKEITHAN Credentialing Specialist 252-752-5156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 9300351) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |