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Organization
LEGACY HEALTHCARE SERVICES INC
Active
Organization
LEGACY HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM G WILSON JR. (CHIEF FINANCIAL OFFICER)
(919) 424-5080
Entity
Organization
Contact information
Practice address
6251 OVERTON RIDGE BLVD, FORT WORTH, TX 76132-3755
(817) 945-1586
Mailing address
110 HORIZON DR STE 310, RALEIGH, NC 27615-4926
(984) 308-8197
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/05/2021
Last updated
12/06/2024
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