| NPI | 1265678817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG COLLINS Assistant Athletic Director 336-758-5620 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2015-08-19 |