Organization
LEGACY HEALTHCARE SERVICES, INC
Active
Other names
Legacy Healthcare at Fort Wayne
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM GIL WILSON JR. (CHIEF FINANCIAL OFFICER)
(919) 424-5080
Entity
Organization
Contact information
Practice address
5202 SAINT JOE RD APT 340, FORT WAYNE, IN 46835-3384
(260) 485-6068
Mailing address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
(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
02/24/2014
Last updated
03/05/2021
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