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General NPI Number Information
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NPI Number | 1013878719
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Entity Type | Organization
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Legal Business Name | THE WELLNESS STATION 2, LLC
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 3500 WESTGATE DR STE 504
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City | DURHAM
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State | NC
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Zip | 27707-2568
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Country | US
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Telephone | 919-489-8809
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 N FORK RD
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711-2513
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JACOB TYSON
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Credential | DPT
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Telephone | 919-951-8457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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