Organization
LEGACY HEALTHCARE SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK WOODLEY CLARK PTA (PTA)
(828) 448-1137
Entity
Organization
Contact information
Practice address
4263 BILL DALE RD, MORGANTON, NC 28655
(828) 448-1137
Mailing address
4263 BILL DALE RD, MORGANTON, NC 28655-8854
(828) 448-1137
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
5172
NC
314000000X
Skilled Nursing Facility
Primary
5172
NC
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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