| NPI | 1639680945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE JOHNSON President 919-973-8827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P11704) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2024-02-14 |