Healthcare Provider Details

I. General information

NPI: 1881510956
Provider Name (Legal Business Name): CAROLINA SZ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 EASTWOOD RD STE 5-1E
WILMINGTON NC
28403-3640
US

IV. Provider business mailing address

513 FLAGLER DR
WILMINGTON NC
28411-7269
US

V. Phone/Fax

Practice location:
  • Phone: 910-239-9333
  • Fax:
Mailing address:
  • Phone: 910-228-9277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT CLANTON LENNON JR.
Title or Position: OWNER
Credential:
Phone: 910-228-9277