| NPI | 1821192220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHEDA BROUGHTON Manager, Credntialing 252-248-3313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2024-12-06 |