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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