| NPI | 1275002461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON DUPLESSIS Owner/Manager 910-536-5667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2019-06-11 |