Organization
NEUROGENESIS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNMARIE DORA QUILTY OTR/L (OCCUPATIONAL THERAPIST)
(703) 980-6021
Entity
Organization
Contact information
Practice address
4104 HAMPTON PARK WAY, FUQUAY VARINA, NC 27526-5475
(703) 980-6021
Mailing address
4104 HAMPTON PARK WAY, FUQUAY VARINA, NC 27526-5475
(703) 980-6021
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
07/11/2021
Last updated
07/11/2021
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