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General NPI Number Information
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NPI Number | 1265149371
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Entity Type | Organization
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Legal Business Name | CHARLOTTE ONE MORE GO PHYSICAL THERAPY & WELLNESS LLC
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 1206 ELVASTON CIR
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City | CHARLOTTE
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State | NC
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Zip | 28214-3408
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Country | US
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Telephone | 347-296-6572
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Fax |
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Provider Business Mailing Address
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Address Line | 120 SPARKLEBERRY CROSSING RD STE 1B
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City | COLUMBIA
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State | SC
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Zip | 29229-8626
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Country | US
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Telephone | 803-667-9432
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Fax | 803-667-9566
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Authorized Official
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Title or Position | OWNER
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Name | SHERMAN LEON ROBERTS
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Credential |
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Telephone | 980-595-4404
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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 |
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License Number State |
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