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General NPI Number Information
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NPI Number | 1225302276
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Entity Type | Organization
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Legal Business Name | CAROLINA KIDS PT SERVICES, INC
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 2426 NARROW GAUGE RD
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City | REIDSVILLE
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State | NC
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Zip | 27320-7717
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Country | US
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Telephone | 336-613-7201
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Fax | 336-634-1559
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Provider Business Mailing Address
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Address Line | 2426 NARROW GAUGE RD
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City | REIDSVILLE
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State | NC
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Zip | 27320-7717
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Country | US
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Telephone | 336-613-7201
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Fax | 336-634-1559
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KATHRYN S DAVIS
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Credential | PT
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Telephone | 336-613-7201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1997
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License Number State | NC
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