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NPI Code Detail

MEDICARE: REILLY BARTLETT ROUTH DPT

MEDICARE: REILLY BARTLETT ROUTH DPT
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
1225100000XPhysical TherapistP24028NC

General Provider Information

NPI Number : 1215820691
Entity Type Code : Individual
Provider Name (Legal Business Name) : REILLY BARTLETT ROUTH DPT
Provider Business Mailing Address
First Line : 2308 TULIP BLOOM LN
Second Line :
City : MORRISVILLE
State : NC
Zip : 27560-5332
Country : US
Telephone Number : 803-261-2050
Fax Number :
Provider Business Practice Location Address
First Line : 2300 GALLBERRY LN
Second Line :
City : WAXHAW
State : NC
Zip : 28173-0161
Country : US
Telephone Number : 803-261-2050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2025
Last Update Date : 01/08/2026

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