Organization
LEGACY HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM G WILSON JR. (CFO)
(919) 424-5080
Entity
Organization
Contact information
Practice address
190 RIVER PARK DR, LITTLE RIVER, SC 29566-6844
(855) 239-3467
Mailing address
110 HORIZON DR STE 310, RALEIGH, NC 27615-4926
(910) 724-7770
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
05/05/2020
Last updated
09/08/2021
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