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NPI Code Detail

MEDICARE: KINETIC PHYS THERAPY AND WELLNESS INC

MEDICARE: KINETIC PHYS THERAPY AND WELLNESS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1063733442
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINETIC PHYS THERAPY AND WELLNESS INC
Provider Business Mailing Address
First Line : 1540 E ARLINGTON BLVD
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-5870
Country : US
Telephone Number : 252-364-2806
Fax Number : 252-364-2863
Provider Business Practice Location Address
First Line : 1540 E ARLINGTON BLVD
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-5870
Country : US
Telephone Number : 252-364-2806
Fax Number : 252-364-2863
Authorized Official
Title or Position : PRESIDENT
Name : DR. CHARLIE DAVID EDWARDS
Credential : PT, DPT
Telephone Number : 252-902-7061
Provider Enumeration Date : 06/19/2010
Last Update Date : 06/13/2016

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Directions to “KINETIC PHYS THERAPY AND WELLNESS INC ” Practice Location

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