| NPI | 1699967547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN P DAVENPORT Office Mgr 336-778-0292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2008-04-18 |