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General NPI Number Information
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NPI Number | 1588457410
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Entity Type | Organization
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Legal Business Name | EVERBLOOM PELVIC HEALTH, PLLC
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 2010 PAUL ST
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City | SANFORD
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State | NC
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Zip | 27330-8206
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Country | US
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Telephone | 423-741-6797
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 PAUL ST
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City | SANFORD
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State | NC
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Zip | 27330-8206
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Country | US
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Telephone | 423-741-6797
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/OWNER
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Name | STEPHANIE SMITH
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Credential |
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Telephone | 423-741-6797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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