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Organization
SOUTHERN PINES PHYSICAL THERAPY, LLC
Active
Organization
SOUTHERN PINES PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN G STOVALL PT (PARTNER)
(910) 692-8269
Entity
Organization
Contact information
Practice address
210 S BENNETT ST, SOUTHERN PINES, NC 28387-5402
(910) 692-8269
Mailing address
210 S BENNETT ST, SOUTHERN PINES, NC 28387-5402
(910) 692-8269
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2089
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015AG
BCBSNC GROUP
NC
01
—
FH60000150
FIRST CAROLINA GROUP
NC
Enumeration date
06/01/2006
Last updated
08/22/2020
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