Individual
TERESA M. FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.O.T. OTR L
Contact information
Practice address
3716 NATIONAL DR, SUITE 124, RALEIGH, NC 27612-4068
(919) 815-0638
Mailing address
3512 FOY GLEN CT, APEX, NC 27539-3682
(919) 815-0638
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4712
NC
Other
Enumeration date
02/16/2007
Last updated
10/05/2015
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