| NPI | 1407197643 |
|---|---|
| Doing Business As | NOVANT HEALTH LAKESIDE PHYSICAL THERAPY & SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | SHALA DAVIS Managed Care Manager 704-303-7517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2021-08-17 |