| NPI | 1134265176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA MIXSON LYON Executive Director 336-375-3575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2025-09-11 |