Organization
KIDSCAN THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMI GLYNN TUCKER OTR/L (OWNER)
(336) 408-0821
Entity
Organization
Contact information
Practice address
523 LYNCHBURG RD, PILOT MOUNTAIN, NC 27041-9326
(336) 408-0821
(336) 232-1411
Mailing address
PO BOX 1107, KING, NC 27021-1107
(336) 408-0821
(336) 922-1218
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4662
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7302190
—
NC
Enumeration date
06/25/2009
Last updated
03/27/2018
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