| NPI | 1669493474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHEDA BROUGHTON Credentialing Manager 252-248-3313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-11-19 |