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General NPI Number Information
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NPI Number | 1790164697
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Entity Type | Organization
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Legal Business Name | KINETIC PHYSICAL THERAPY & SPORTS REHABILITATION, INC
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Dates
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Enumeration Date | 05/26/2015
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 3048 N CENTER ST
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City | HICKORY
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State | NC
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Zip | 28601-1101
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Country | US
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Telephone | 828-855-9955
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Fax |
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Provider Business Mailing Address
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Address Line | 3048 N CENTER ST
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City | HICKORY
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State | NC
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Zip | 28601-1101
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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 | PHYSICAL THERAPIST/ OWNER
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Name | ALAN CHEUNG
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Credential |
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Telephone | 828-855-9955
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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 | NC14258
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License Number State | NC
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