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General NPI Number Information
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NPI Number | 1689286122
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Entity Type | Organization
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Legal Business Name | 2662 PURSUITS LLC
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 279 PARAGON PKWY
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City | CLYDE
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State | NC
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Zip | 28721-8509
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Country | US
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Telephone | 828-246-6104
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Fax | 828-246-0114
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Provider Business Mailing Address
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Address Line | 279 PARAGON PKWY
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City | CLYDE
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State | NC
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Zip | 28721-8509
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Country | US
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Telephone | 828-246-6104
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Fax | 828-246-0114
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Authorized Official
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Title or Position | CLINIC OWNER AND DIRECTOR
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Name | MRS. JENNIFER ANNA CURVIN
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Credential | PTA
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Telephone | 828-246-6104
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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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