| NPI | 1578612297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD JOHN TANANIS Owner/Sole Proprietor 252-451-3734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2009-10-15 |