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Athelite Physical Performance Center Of Lake Norman, LLC

Physical Therapist in Statesville, NC. Organization (NPI-2).

NPI number1669772802
StatusActive
Last updated in NPPESJan 13, 2011

Details

NPI
1669772802
Entity type
Organization (NPI-2)
Legal business name
Athelite Physical Performance Center Of Lake Norman, LLC
Organization subpart
No
Enumeration date
Oct 21, 2010
Last updated
Jan 13, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist––Yes

Other names

  • Athelite Ppc (Doing Business As)

Practice location

2809 Amity Hill Rd
Statesville, NC 28677-9744

Phone 704-768-1013 · Fax 704-264-0711

Mailing address

1385 E Garrison Blvd
Gastonia, NC 28054-5127

Phone 704-768-1013 · Fax 704-264-0711

Authorized official

Brian J Boyle
Ceo
7042410889

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