Healthcare Provider Details

I. General information

NPI: 1689286122
Provider Name (Legal Business Name): 2662 PURSUITS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 08/17/2020
Certification Date: 08/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 PARAGON PKWY
CLYDE NC
28721-8509
US

IV. Provider business mailing address

279 PARAGON PKWY
CLYDE NC
28721-8509
US

V. Phone/Fax

Practice location:
  • Phone: 828-246-6104
  • Fax: 828-246-0114
Mailing address:
  • Phone: 828-246-6104
  • Fax: 828-246-0114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JENNIFER ANNA CURVIN
Title or Position: CLINIC OWNER AND DIRECTOR
Credential: PTA
Phone: 828-246-6104