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General NPI Number Information
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NPI Number | 1164401568
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY FOR THE CAROLINAS
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 3315 SPRINGBANK LN SUITE 104
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City | CHARLOTTE
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State | NC
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Zip | 28226-3197
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Country | US
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Telephone | 704-541-3378
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Fax | 704-542-5962
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Provider Business Mailing Address
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Address Line | 3315 SPRINGBANK LN SUITE 104
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City | CHARLOTTE
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State | NC
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Zip | 28226-3197
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Country | US
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Telephone | 704-541-3378
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. THOMAS S CAMPION
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Credential | PT, OCS
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Telephone | 704-541-3378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5257
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License Number State | NC
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