Healthcare Provider Details

I. General information

NPI: 1720910318
Provider Name (Legal Business Name): KINGDOM WELLNESS & REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1953 SHIRLEY DR
BURLINGTON NC
27215-4831
US

IV. Provider business mailing address

1953 SHIRLEY DR
BURLINGTON NC
27215-4831
US

V. Phone/Fax

Practice location:
  • Phone: 336-745-1068
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA JAMES KUENZLI
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 704-298-9393