Organization
ACTIVCARE PHYSICAL THERAPY, LLC
Active
Organization
ACTIVCARE PHYSICAL THERAPY, LLC
Active
Other names
Pivot Physical Therapy of the Carolinas
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
1009 STADIUM DR STE 124, WAKE FOREST, NC 27587-4687
(919) 453-5910
(919) 322-0041
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(252) 248-3313
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/02/2020
Last updated
12/09/2024
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