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Organization
LILLINGTON PHYSICAL THERAPY
Active
Organization
LILLINGTON PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DAWN LEAIRD PT (PRESIDENT)
(321) 698-6819
Entity
Organization
Contact information
Practice address
55 BAIN STREET, SUITE 101, LILLINGTON, NC 27546-9236
(910) 814-5885
(910) 814-8558
Mailing address
144 ADCOCK RD, LILLINGTON, NC 27546-9236
(910) 814-5885
(910) 814-8558
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6118
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12012313
CAQH
NC
01
—
1730463035
NPI
NC
Enumeration date
10/05/2011
Last updated
12/06/2011
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