MEDICARE: ROBERT HAMILTON PRENGLE PT

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
1	225100000X	Physical Therapist	P18099	NC

General Provider Information

NPI Number	:	1275057689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT HAMILTON PRENGLE PT

Provider Business Mailing Address
First Line	:	6241 WESTGATE RD STE 100
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27617-5975
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6241 WESTGATE RD STE 100
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27617-5975
Country	:	US
Telephone Number	:	202-681-1474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2017
Last Update Date	:	05/27/2026

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