Healthcare Provider Details

I. General information

NPI: 1003118977
Provider Name (Legal Business Name): KARAN BOBBY JOHAR D.P.T
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 11/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 SHAMROCK DR
CHARLOTTE NC
28215-3220
US

IV. Provider business mailing address

2514 CRANBROOK LN APT 2
CHARLOTTE NC
28207-2042
US

V. Phone/Fax

Practice location:
  • Phone: 704-532-7000
  • Fax:
Mailing address:
  • Phone: 716-907-4513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: