| NPI | 1144760273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA LEE GOULET Medical Massage Practitioner 252-305-0285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NC 14500) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: NC 14500) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: NC 14500) | |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2017-03-08 |