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General NPI Number Information
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NPI Number | 1649360686
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Entity Type | Organization
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Legal Business Name | CAWH REHABILITATION SERVICES, LLC.
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 10116 OLD LIBERTY RD
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City | LIBERTY
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State | NC
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Zip | 27298-8072
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Country | US
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Telephone | 336-622-9641
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Fax | 336-622-9713
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Provider Business Mailing Address
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Address Line | 10116 OLD LIBERTY RD PO BOX 486
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City | LIBERTY
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State | NC
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Zip | 27298-8072
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Country | US
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Telephone | 336-622-9641
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Fax | 336-622-9713
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | MRS. KIM MARTIN
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Credential |
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Telephone | 336-622-9641
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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 |
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License Number State | NC
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