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General NPI Number Information
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NPI Number | 1407660608
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Entity Type | Organization
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Legal Business Name | ENDURANCE UNLEASHED, LLC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 47 STONE BRIDGE XING
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City | CHAPEL HILL
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State | NC
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Zip | 27517-7016
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Country | US
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Telephone | 516-387-4669
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Fax |
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Provider Business Mailing Address
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Address Line | 47 STONE BRIDGE XING
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City | CHAPEL HILL
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State | NC
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Zip | 27517-7016
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Country | US
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Telephone | 516-387-4669
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. ROBERT WILLIAM BERGHORN JR.
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Credential | DPT, ATC, USAW
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Telephone | 516-387-4669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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