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1164178372
HOSSAM IDRISSI BOUCTEB
RALEIGH, NC
NPI
1164178372
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NC P21044)
Enumeration Date
2022-02-25
Last Update Date
2023-08-15
Business Address
HOSSAM IDRISSI BOUCTEB
4109 WAKE FOREST RD STE 200
RALEIGH, NC 27609-6262
Phone number: 919-322-0042
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Mailing Address
HOSSAM IDRISSI BOUCTEB
504 HYANNIS DR
HOLLY SPRINGS, NC 27540-8331
Phone number: 919-633-2324
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