| NPI | 1619624590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUENTON T HENSON Owner 704-965-3795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 225XE0001X Occupational Therapist Environmental Modification | |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2022-03-09 |