Healthcare Provider Details

I. General information

NPI: 1154548337
Provider Name (Legal Business Name): CAROLINA PHYSICAL THERAPY ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2413 PROFESSIONAL DR
ROCKY MOUNT NC
27804-2254
US

IV. Provider business mailing address

2413 PROFESSIONAL DR
ROCKY MOUNT NC
27804-2254
US

V. Phone/Fax

Practice location:
  • Phone: 252-443-0808
  • Fax: 252-451-9032
Mailing address:
  • Phone: 252-443-0808
  • Fax: 252-451-9032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number2824
License Number StateNC

VIII. Authorized Official

Name: MRS. SUEELLA JOHNSON
Title or Position: DIRECTOR OF OPERATIONS
Credential: LPT
Phone: 252-535-8268