| NPI | 1811693088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN FISHER Credentialing 704-832-5383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2024-07-30 |