Most Relevant Information
Provider Data
| NPI Number: | 1003522459 |
| Provider Name: | LARA KELLY PERRETTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225400000X |
| Specialty: | Rehabilitation Practitioner |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/30/2023 |
| Last Updated: | 08/30/2024 |
Provider Practice Location
2744 S 17TH ST
WILMINGTON
NC
284126606
Practice Location Phone/Fax
| Phone: | 9104521114 |
| Fax: |
Provider Mailing Location
2744 S 17TH ST
WILMINGTON
NC
284126606
Provider Mailing Phone/Fax
| Phone: | 9104521114 |
| Fax: |