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Rita L Defazio, PT

Specialist in Winston Salem, NC. Individual provider (NPI-1).

NPI number1174743058
StatusActive
Last updated in NPPESMar 11, 2011

Details

NPI
1174743058
Entity type
Individual (NPI-1)
Name
Ms. Rita L Defazio
Credential
PT
Sex
Female
Sole proprietor
No
Enumeration date
Apr 26, 2007
Last updated
Mar 11, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174400000X SpecialistPT35845CAYes
174400000X Specialist11341NC
174400000X Specialist––

Practice location

380h Knollwood St # 133
Winston Salem, NC 27103-1815

Phone 336-692-6820

Mailing address

380h Knollwood St #133
Winstonsalem, NC 27103

Phone 336-692-6820

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