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General NPI Number Information
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NPI Number | 1710639190
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Entity Type | Organization
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Legal Business Name | CAROLINA PT SOLUTIONS LLC
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Dates
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Enumeration Date | 01/26/2022
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | 11218 PROVIDENCE RD W STE C
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City | CHARLOTTE
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State | NC
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Zip | 28277-4787
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Country | US
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Telephone | 704-780-1558
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Fax |
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Provider Business Mailing Address
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Address Line | 5047 SAINT CLAIR ST
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City | FORT MILL
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State | SC
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Zip | 29715-7607
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BARTOSZ NIKICIUK
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Credential | PT
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Telephone | 704-780-1558
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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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