| 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 |