Organization
PHYSICAL THERAPY FOR WOMEN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER R SHEPHERD PT (OWNER/PHYSICAL THERAPIST)
(910) 798-2318
Entity
Organization
Contact information
Practice address
1630 MILITARY CUTOFF RD STE 110, WILMINGTON, NC 28403-5719
(910) 798-2318
(910) 798-2319
Mailing address
5919 OLEANDER DR, SUITE 123, WILMINGTON, NC 28403-4780
(910) 798-2318
(910) 798-2319
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4865
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017WJ
BLUE CROSS BLUE SHIELD
NC
01
—
2320258
HUMANA
NC
05
—
7211054
—
NC
Enumeration date
01/15/2008
Last updated
02/27/2020
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