Provider Demographics
NPI:1770768798
Name:NEUSE RIVER THERAPY P.A.
Entity type:Organization
Organization Name:NEUSE RIVER THERAPY P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TUOHY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:919-906-1270
Mailing Address - Street 1:2632 DUNLORING DR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9021
Mailing Address - Country:US
Mailing Address - Phone:919-562-2935
Mailing Address - Fax:
Practice Address - Street 1:8520 SIX FORKS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3095
Practice Address - Country:US
Practice Address - Phone:919-906-1270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5238174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty