MEDICARE: ADVANCED HEALTH AND REHABILITATION OF NEW BERN

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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1558838755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HEALTH AND REHABILITATION OF NEW BERN

Provider Business Mailing Address
First Line	:	504 RED BANKS RD STE C
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5766
Country	:	US
Telephone Number	:	252-321-3579
Fax Number	:	252-321-3576

Provider Business Practice Location Address
First Line	:	3338 WELLONS BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5290
Country	:	US
Telephone Number	:	252-631-5353
Fax Number	:	252-631-5354

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BRIAN M KEAN
Credential	:	DC
Telephone Number	:	252-321-3579

Provider Enumeration Date	:	10/26/2018
Last Update Date	:	10/26/2018

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