Healthcare Provider Details

I. General information

NPI: 1528880358
Provider Name (Legal Business Name): MARYHOLLAND RAUSHER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2024
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6509 W WILKINSON BLVD STE 102B
BELMONT NC
28012-2891
US

IV. Provider business mailing address

1429 BRYANT ST STE A
CHARLOTTE NC
28208-5201
US

V. Phone/Fax

Practice location:
  • Phone: 980-301-9996
  • Fax: 980-301-9996
Mailing address:
  • Phone: 704-919-0867
  • Fax: 704-817-8579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP24313
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT032666
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: