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NPI Code Detail

MEDICARE: EASTERN THERAPY SOLUTIONS, PLLC

MEDICARE: EASTERN THERAPY SOLUTIONS, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant
2225100000XPhysical Therapist
3235Z00000XSpeech-Language Pathologist
4225X00000XOccupational Therapist

General Provider Information

NPI Number : 1073143343
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTERN THERAPY SOLUTIONS, PLLC
Provider Business Mailing Address
First Line : 9020 SENCA DR STE 220
Second Line :
City : WILMINGTON
State : NC
Zip : 28411-6680
Country : US
Telephone Number : 252-227-0251
Fax Number : 910-442-8372
Provider Business Practice Location Address
First Line : 9020 SENCA DR STE 220
Second Line :
City : WILMINGTON
State : NC
Zip : 28411-6680
Country : US
Telephone Number : 252-227-0251
Fax Number : 910-442-8372
Authorized Official
Title or Position : OWNER
Name : BROOKE WALLACE
Credential :
Telephone Number : 252-227-0251
Provider Enumeration Date : 01/24/2020
Last Update Date : 05/03/2022

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Directions to “EASTERN THERAPY SOLUTIONS, PLLC ” Practice Location

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