Organization
BREAKTHROUGH SC LLC
Active
Other names
Your Life Wellness & Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY W HATHAWAY (CEO)
(315) 458-2552
Entity
Organization
Contact information
Practice address
2514 CUTHBERTSON RD STE D, WAXHAW, NC 28173-6417
(704) 810-4302
(704) 705-4588
Mailing address
981 HIGH HOUSE RD STE 100, CARY, NC 27513-3510
(919) 377-8744
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
03/18/2020
Last updated
03/18/2020
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