Organization
PULSE SPORT WEAR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN SMITH (CEO)
(704) 496-0501
Entity
Organization
Contact information
Practice address
818 FRIENDLY PL, CHARLOTTE, NC 28213-5800
(704) 496-0501
Mailing address
818 FRIENDLY PL, CHARLOTTE, NC 28213-5800
(704) 496-0501
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
—
—
225800000X
Recreation Therapist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
12/31/2014
Last updated
12/31/2014
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