Organization
WIDRICK OCCUPATIONAL THERAPY SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEAN MATTHEW WIDRICK MS, OTR/L (PRESIDENT)
(919) 815-4389
Entity
Organization
Contact information
Practice address
105 CANTERSTONE CT, CARY, NC 27518-2251
(919) 815-4389
Mailing address
105 CANTERSTONE CT, CARY, NC 27518-2251
(919) 815-4389
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4143
NC
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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