Organization
DYNAMIC THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER C CREDLE PT (OWNER, DIRECTOR)
(919) 363-5000
Entity
Organization
Contact information
Practice address
2920 RIDGEPINE DR, APEX, NC 27502-7934
(919) 363-5000
(919) 353-5346
Mailing address
2920 RIDGEPINE DR, APEX, NC 27502-7934
(919) 363-5000
(919) 363-5346
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
1311
NC
2251P0200X
Pediatric Physical Therapist
2152
NC
2251P0200X
Pediatric Physical Therapist
2215
NC
2251P0200X
Pediatric Physical Therapist
3786
NC
225XP0200X
Pediatric Occupational Therapist
4215
NC
225XP0200X
Pediatric Occupational Therapist
4734
NC
225XP0200X
Pediatric Occupational Therapist
5261
NC
235Z00000X
Speech-Language Pathologist
Primary
6205
NC
235Z00000X
Speech-Language Pathologist
6426
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7201000
—
NC
05
—
7201106
—
NC
05
—
7207861
—
NC
05
—
7207890
—
NC
05
—
7210194
—
NC
05
—
7210370
—
NC
05
—
7211723
—
NC
05
—
7301807
—
NC
05
—
731037U
—
NC
05
—
7412015
—
NC
05
—
8300158
—
NC
Enumeration date
06/28/2006
Last updated
12/17/2020
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