Individual
GENIEVE ROA VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27710
(919) 681-2030
Mailing address
1603B W CLUB BLVD, DURHAM, NC 27705-3518
(732) 779-4532
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17947
NC
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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