Healthcare Provider Details
I. General information
NPI: 1245058049
Provider Name (Legal Business Name): LIMITLESS NEUROWELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7107 HERMISTON ST
CHARLOTTE NC
28273-0621
US
IV. Provider business mailing address
7107 HERMISTON ST
CHARLOTTE NC
28273-0621
US
V. Phone/Fax
- Phone: 704-403-9100
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KELLY
RACHMIEL
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 732-439-0408