Provider Demographics
NPI:1275030272
Name:RDL THERAPEUTIC OUTPATIENT THERAPY
Entity Type:Organization
Organization Name:RDL THERAPEUTIC OUTPATIENT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARNISHA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:910-527-8525
Mailing Address - Street 1:PO BOX 25682
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-5011
Mailing Address - Country:US
Mailing Address - Phone:910-868-2002
Mailing Address - Fax:910-868-2004
Practice Address - Street 1:424 MCARTHUR RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311
Practice Address - Country:US
Practice Address - Phone:910-868-2002
Practice Address - Fax:910-868-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-07
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty