Organization
BALANCED PHYSICAL THERAPY & SPORTS PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA FULTINEER PT (OWNER/PHYSICAL THERAPIST)
(919) 803-1037
Entity
Organization
Contact information
Practice address
6520 FALLS OF NEUSE RD STE 110, RALEIGH, NC 27615-6849
(919) 803-1037
Mailing address
2620 KINLAWTON PL, RALEIGH, NC 27614-9867
(717) 615-2704
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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