MEDICARE: RANGE OF MOTION PHYSICAL THERAPY

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
1	261QP2000X	Physical Therapy Clinic/Center	10208	NC

General Provider Information

NPI Number	:	1366724833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RANGE OF MOTION PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	3527 OLD AIRPORT RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-8790
Country	:	US
Telephone Number	:	252-288-1866
Fax Number	:	252-514-0053

Provider Business Practice Location Address
First Line	:	608 PINE TREE DR
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-4430
Country	:	US
Telephone Number	:	252-288-1866
Fax Number	:	252-514-0053

Authorized Official
Title or Position	:	OWNER/PHYSICAL THERAPIST
Name	:	MS. CAROLYN LEE DUERR
Credential	:	P.T.
Telephone Number	:	252-288-1866

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	09/12/2011

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Directions to “RANGE OF MOTION PHYSICAL THERAPY ” Practice Location

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