Organization
MILESTONE THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP JOSEPH BISSOONDIAL OTR/L (PRESIDENT)
(704) 649-4509
Entity
Organization
Contact information
Practice address
2300 GALLBERRY LN, WAXHAW, NC 28173-0161
(704) 649-4509
(704) 843-9045
Mailing address
2300 GALLBERRY LN, WAXHAW, NC 28173-0161
(704) 649-4509
(704) 843-9045
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7200201
—
NC
05
—
NPC106
—
SC
Enumeration date
03/05/2008
Last updated
10/05/2023
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