NPI | 1902983794 |
---|---|
Entity Type | Organization |
Authorized Contact | MARISKA CHARLENE TRUESDALE Owner 910-619-4803 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 4979) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2007-09-20 |