Healthcare Provider Details

I. General information

NPI: 1043318876
Provider Name (Legal Business Name): JAMES RICHARD STRICKLAND A.T.C., L.A.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 MARKET ST
WILMINGTON NC
28401-4331
US

IV. Provider business mailing address

PO BOX 640
CAROLINA BEACH NC
28428-0640
US

V. Phone/Fax

Practice location:
  • Phone: 910-251-6100
  • Fax: 910-251-6114
Mailing address:
  • Phone: 910-251-6100
  • Fax: 910-251-6114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number0265
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: