Organization
AQUATIC PHYSICAL THERAPY & BEYOND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE OLIVOTTI (CEO)
(919) 870-4444
Entity
Organization
Contact information
Practice address
8305 FALLS OF NEUSE RD, STE. 102, RALEIGH, NC 27615-3546
(919) 870-4444
(919) 870-4447
Mailing address
8305 FALLS OF NEUSE RD, STE. 102, RALEIGH, NC 27615-3546
(919) 870-4444
(919) 870-4447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8948
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016K6
BLUE CROSS BLUE SHIELD ID
NC
05
—
7211687
—
NC
01
—
DD0417
RAILROAD MEDICARE
NC
Enumeration date
01/25/2006
Last updated
04/03/2018
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