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General NPI Number Information
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NPI Number | 1962143123
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Entity Type | Organization
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Legal Business Name | MY MOBILITY PHYSICAL THERAPY WELLNESS , LLC
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Dates
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Enumeration Date | 04/03/2022
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Last Update Date | 04/27/2025
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Provider Practice Location Address
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Address Line | 1512 TARRINGTON WAY
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-4358
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Country | US
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Telephone | 704-559-9626
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Fax | 866-635-2322
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Provider Business Mailing Address
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Address Line | 4030 WAKE FOREST RD STE 349
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City | RALEIGH
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State | NC
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Zip | 27609-0010
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Country | US
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Telephone | 704-559-9626
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Fax | 866-635-2322
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | TARSHA ANN GRAHAM
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Credential | DPT
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Telephone | 347-414-3701
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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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