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Organization
TIDAL SPORTS REHAB & RECOVERY LLC
Active
Organization
TIDAL SPORTS REHAB & RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY PATRICIA OROURKE PT, DPT, ATC, LAT (OWNER/PHYSICAL THERAPIST)
(910) 546-5917
Entity
Organization
Contact information
Practice address
138 LONG COVE LN, MOORESVILLE, NC 28117-5827
(910) 546-5917
Mailing address
138 LONG COVE LN, MOORESVILLE, NC 28117-5827
(910) 546-5917
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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