| NPI | 1265739239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICA MITCHELL President 910-583-9471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P9546) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NC A773) |
| Enumeration Date | 2011-02-27 |
| Last Update Date | 2013-10-28 |