Organization
EASTER SEALS UCP NC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOREEN SORRENTINO (ASST DIRECTOR)
(704) 522-9912
Entity
Organization
Contact information
Practice address
716 MARSH RD, CHARLOTTE, NC 28209-1851
(704) 522-9912
(704) 522-9914
Mailing address
716 MARSH RD, CHARLOTTE, NC 28209-1851
(704) 522-9912
(704) 522-9914
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
9217
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7211769
—
NC
Enumeration date
02/05/2007
Last updated
08/22/2020
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