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NPI Code Detail

MEDICARE: COMPREHENSIVE REHABILITATION OF THE CAROLINAS, PLLC

MEDICARE: COMPREHENSIVE REHABILITATION OF THE CAROLINAS, PLLC
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
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1881647006
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE REHABILITATION OF THE CAROLINAS, PLLC
Provider Business Mailing Address
First Line : PO BOX 38176
Second Line :
City : CHARLOTTE
State : NC
Zip : 28278-1002
Country : US
Telephone Number : 704-942-5872
Fax Number : 866-227-0449
Provider Business Practice Location Address
First Line : 600 FULLWOOD RD
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-2659
Country : US
Telephone Number : 704-942-5872
Fax Number : 866-227-0449
Authorized Official
Title or Position : OWNER
Name : AKIKO OMURA
Credential : MD
Telephone Number : 704-942-5872
Provider Enumeration Date : 05/18/2006
Last Update Date : 08/22/2020

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