Individual
DARYL SUPENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1703 FAIRFAX RD, APT G, GREENSBORO, NC 27407-4184
(336) 299-0031
Mailing address
1703 FAIRFAX RD, APT G, GREENSBORO, NC 27407-4184
(203) 517-8082
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14836
NC
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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