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NPI Code Detail

MEDICARE: ROUSLAN PETROVICH RECHETNIKOV

MEDICARE: ROUSLAN PETROVICH RECHETNIKOV
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist7404NC

General Provider Information

NPI Number : 1063267003
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROUSLAN PETROVICH RECHETNIKOV
Provider Business Mailing Address
First Line : 123 HEDGEROW CT
Second Line :
City : CARY
State : NC
Zip : 27513-4231
Country : US
Telephone Number : 419-902-8326
Fax Number :
Provider Business Practice Location Address
First Line : 2420 LAKE WHEELER RD
Second Line :
City : RALEIGH
State : NC
Zip : 27603-2614
Country : US
Telephone Number : 419-902-8326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2024
Last Update Date : 04/23/2024

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Directions to “ ROUSLAN PETROVICH RECHETNIKOV ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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