NPI | 1275984114 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWNA LEA MCCORMICK Owner/ Physical Therapist 910-689-5071 |
Organization Subpart ? | No |
Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: KY 003960) |
Enumeration Date | 2016-06-22 |
Last Update Date | 2020-06-19 |