# KINETIC PEDIATRIC THERAPY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831081751
- **Authorized official:** CHARLIE DAVID EDWARDS DPT (CO-OWNER)
- **Authorized official phone:** (252) 902-7061

## Contact information

- **Practice address:** 1540 E ARLINGTON BLVD, GREENVILLE, NC 27858-5870
- **Practice address phone:** (252) 902-7061
- **Practice address fax:** (252) 364-2863
- **Mailing address:** 1540 E ARLINGTON BLVD, GREENVILLE, NC 27858-5870
- **Mailing address phone:** (252) 902-7061
- **Mailing address fax:** (252) 364-2863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | Yes |
| 103K00000X | Behavior Analyst | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2025
- **Last updated:** 07/16/2025