| NPI | 1790096485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY EUGENE LEATHERMAN President 336-391-7892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 8012) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2010-10-15 |