| NPI | 1396874269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA W SULLIVAN VP Accts Receivable Manager 251-586-0067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH1122) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |