Gridiron247

NPI 1003204934 - Physical Therapist - 225100000X

NPI Details
NPI 1003204934
Enumeration Date 12/30/2014
Last Updated 12/30/2014
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name JERRIS JERRIS
Position MANAGER
Phone (910) 525-3088
Fax
Practice Location
210 W MARTIN L. KING BLVD
ROSEBORO NC, 28382-9066, US
Phone (910) 525-3088
Fax
Business Location
210 W MARTIN LUTHER KING BLVD
ROSEBORO NC, 28382-9066, US
Phone (910) 525-3088
Fax
Toxanomy
Taxonomy Code 225100000X
License State
License Number
Remove 1003204934 NPI Number
 

According to our database, Gridiron247 NPI is 1003204934, taxonomy code is 225100000X Gridiron247 physically located at 210 W Martin L. King Blvd, Roseboro NC, 28382-9066. NPI Number 1033115704 has the healthcare provider type.

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1003204934 NPI number is provided on an as is basis without warranty of any kind. 1003204934 is maintained by the National Plan & Provider Enumeration System. The contents of Gridiron247 are for informational purposes only.