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Organization

BABY STEPS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER RENEE DICICCO DPT (DOCTOR OF PHYSICAL THERAPY)
(980) 585-9950
Entity
Organization

Contact information

Practice address
3254 PENDLETON AVE, CHARLOTTE, NC 28210-4708
(980) 585-9950
(704) 981-6178
Mailing address
3254 PENDLETON AVE, CHARLOTTE, NC 28210-4708
(571) 244-2220

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125584330
INDIVIDUAL NPI 1
NC
Enumeration date
01/11/2021
Last updated
01/11/2021
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