Organization
INNOVATIVE OT NC LLC
Active
Other names
Innovative OT NC, LLC, Innovative OT NC LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN TRACY JOHNSON OT (OWNER)
(919) 244-8367
Entity
Organization
Contact information
Practice address
412 FIRE OPAL LANE, HOLLY SPRINGS, NC 27540
(919) 244-8367
Mailing address
644 HOLLY SPRINGS RD STE 148, HOLLY SPRINGS, NC 27540-9030
(919) 244-8367
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
05/06/2022
Last updated
07/21/2022
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