Organization
PLATINUM THERAPY & PERFORMANCE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY EDWARDS ATC, LAT (MANAGER)
(910) 740-5882
Entity
Organization
Contact information
Practice address
296 BAXLEY RD, SAINT PAULS, NC 28384-6766
(910) 740-5882
Mailing address
296 BAXLEY RD, SAINT PAULS, NC 28384-6766
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/19/2020
Last updated
02/19/2021
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