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NPI Code Detail

MEDICARE: SPECIALIZED PHYSICAL THERAPY OF THE CAROLINAS LLC

MEDICARE: SPECIALIZED PHYSICAL THERAPY OF THE CAROLINAS LLC
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 Therapist
2261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1316580574
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECIALIZED PHYSICAL THERAPY OF THE CAROLINAS LLC
Provider Business Mailing Address
First Line : 408 HIGUERA ST STE 200
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-6135
Country : US
Telephone Number : 805-788-0805
Fax Number : 805-788-0845
Provider Business Practice Location Address
First Line : 101 E ALLEN ST STE 103
Second Line :
City : HENDERSONVILLE
State : NC
Zip : 28792-5091
Country : US
Telephone Number : 828-417-0160
Fax Number : 828-417-3151
Authorized Official
Title or Position : PRESIDENT
Name : KELLY MARIE SANDERS
Credential : PT, DPT
Telephone Number : 805-788-0805
Provider Enumeration Date : 10/21/2019
Last Update Date : 04/10/2023

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Directions to “SPECIALIZED PHYSICAL THERAPY OF THE CAROLINAS LLC ” Practice Location

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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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