Organization
LEGACY HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM G WILSON JR. (CHIEF FINANCIAL OFFICER)
(919) 424-5080
Entity
Organization
Contact information
Practice address
10300 THREE CHOPT RD APT 222, HENRICO, VA 23233-2072
(804) 477-7693
(804) 510-0684
Mailing address
110 HORIZON DR STE 310, RALEIGH, NC 27615-4926
(910) 724-7770
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
10/03/2019
Last updated
07/29/2022
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