Vine Physical Therapy Physical Therapist | |
3808 Tritonville Way, Raleigh, NC 27616-9207 | |
(919) 889-2408 | |
Not Available |
Full Name | Vine Physical Therapy Physical Therapist |
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Type | Facility |
Speciality | Physical Therapist |
Location | 3808 Tritonville Way, Raleigh, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720704158 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Obinna Chika Ezeamurunamma |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1558924928 PECOS PAC ID: 6901137728 Enrollment ID: I20191009002020 |
Mailing Address | Practice Location Address |
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Vine Physical Therapy Physical Therapist 3808 Tritonville Way, Raleigh, NC 27616-9207 Ph: (919) 889-2408 | Vine Physical Therapy Physical Therapist 3808 Tritonville Way, Raleigh, NC 27616-9207 Ph: (919) 889-2408 |
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