| NPI | 1891026803 |
|---|---|
| Doing Business As | INNOVATIVE THERAPY & WELLNESS |
| Entity Type | Organization |
| Authorized Contact | TRACY P INGRAM Operator 252-633-6335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-01-15 |