| NPI | 1467517227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD GRAHAM STOUT Business Manager 336-380-1935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 3076) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-08-22 |