Organization
LEGACY HEALTHCARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY KEESLER PTA (PHYSICAL THERAPIST ASSISTANT)
(716) 307-4960
Entity
Organization
Contact information
Practice address
2800 KIDD RD, RALEIGH, NC 27610-1842
(919) 231-7575
Mailing address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
(919) 424-5086
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A5492
NC
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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