| NPI | 1265481840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDE DANA PADEZANIN President 910-686-6845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 4855) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2020-08-22 |