| NPI | 1780834697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAJA IKOH Credentialing Specialist 704-900-8960 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: NC 2487) |
| Enumeration Date | 2008-09-27 |
| Last Update Date | 2025-03-03 |