Organization
INTEGRATIVE THERAPY CONCEPTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY LYNN GIANOPOULOS OTRL (OWNER OTRL)
(704) 799-6824
Entity
Organization
Contact information
Practice address
134 INFIELD RD, MOORESVILLE, NC 28117-8026
(704) 799-6824
(704) 799-6825
Mailing address
134 INFIELD COURT, MOORESVILLE, NC 28117-8026
(704) 799-6824
(704) 799-6825
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7210778
—
NC
Enumeration date
11/25/2005
Last updated
11/21/2012
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