MEDICARE: CAROLINA RESTORATIVE THERAPY

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1598626251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA RESTORATIVE THERAPY

Provider Business Mailing Address
First Line	:	1735 HECKLE BLVD STE 103-253
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-4803
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1735 HECKLE BLVD STE 103-253
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-4803
Country	:	US
Telephone Number	:	346-507-0477
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROMIRA YOUNG
Credential	:
Telephone Number	:	346-507-0477

Provider Enumeration Date	:	11/21/2025
Last Update Date	:	11/21/2025

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