Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A7381 | NC |
NPI | 1013337062 |
---|---|
Provider Name | Mr. Lorenzo Luis Morales |
First Address | Kernersville, NC 27284-0060 |
Second Address | Winston Salem, NC 27103-3903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2014 |
Last Update Date | 21/12/2021 |