Organization Name: | OUTER PLANETARY TOUCH |
NPI Number: | 1063853158 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAHZARA ISRA (MANAGING MEMBER) |
Mailing Address: | 251 W Main St Albemarle |
State: | NC US |
Postal Code: | 280014816 |
Phone Number: | 9805818433 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2013 |
NPI Last Update Date: | 08/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | P9759 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |