Organization
LEGACY HEALTHCARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM G WILSON JR. (CFO)
(919) 424-5080
Entity
Organization
Contact information
Practice address
2800 S DIXON RD, KOKOMO, IN 46902-6403
(765) 864-0237
(765) 864-0239
Mailing address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2817
(919) 424-5080
(919) 431-9224
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/05/2006
Last updated
05/23/2019
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