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Organization
PRIME OCCUPATIONAL THERAPY PLLC
Active
Organization
PRIME OCCUPATIONAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAHTSENTE WORKU EBRON MSHS OTR/L (OCCUPATIONAL THERAPIST)
(919) 539-8661
Entity
Organization
Contact information
Practice address
1004 PEONY CT, KNIGHTDALE, NC 27545-7051
(919) 539-8661
(919) 373-9564
Mailing address
1004 PEONY CT, KNIGHTDALE, NC 27545-7051
(919) 539-8661
(919) 373-9564
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
4262
NC
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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