Organization
LEGACY HEALTHCARE SERVICES, INC
Active
Organization
LEGACY HEALTHCARE SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM GIL WILSON JR. (CFO)
(919) 424-5080
Entity
Organization
Contact information
Practice address
9642 BURKE LAKE RD, BURKE, VA 22015-3052
(703) 543-7920
(703) 543-7924
Mailing address
110 HORIZON DR STE 310, RALEIGH, NC 27615-4926
(919) 424-5080
(919) 431-9224
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/03/2010
Last updated
08/06/2021
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