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General NPI Number Information
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NPI Number | 1942854351
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Entity Type | Organization
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Legal Business Name | A GRADE REALTY LLC
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 5313 TIMBERTOP LN
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City | CHARLOTTE
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State | NC
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Zip | 28215-7549
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Country | US
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Telephone | 919-673-6917
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Fax | 980-422-0169
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Provider Business Mailing Address
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Address Line | 5313 TIMBERTOP LN
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City | CHARLOTTE
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State | NC
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Zip | 28215-7549
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Country | US
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Telephone | 919-673-6917
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Fax | 980-422-0169
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Authorized Official
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Title or Position | OWNER/ORGANIZER
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Name | MR. AARON COCKBURN
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Credential | OT
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Telephone | 919-673-6917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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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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