| NPI | 1326136797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN ELIZABETH DE JONG Co Owner 252-261-6489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 5494) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-11-08 |