| NPI | 1255082723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHEDA BROUGHTON Credentialing Manager 919-258-2714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-01-15 |
| Last Update Date | 2025-01-30 |