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General NPI Number Information
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NPI Number | 1144406539
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY FOR WOMEN, INC
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Dates
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Enumeration Date | 01/15/2008
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 1630 MILITARY CUTOFF RD STE 110
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City | WILMINGTON
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State | NC
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Zip | 28403-5719
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Country | US
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Telephone | 910-798-2318
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Fax | 910-798-2319
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Provider Business Mailing Address
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Address Line | 5919 OLEANDER DR SUITE 123
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City | WILMINGTON
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State | NC
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Zip | 28403-4780
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Country | US
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Telephone | 910-798-2318
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Fax | 910-798-2319
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MRS. JENNIFER R SHEPHERD
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Credential | PT
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Telephone | 910-798-2318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4865
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License Number State | NC
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