| NPI | 1285609560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY POULOS Owner 910-799-4199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2008-04-20 |