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NPI Code Detail

MEDICARE: CAROLINA REHAB CONSULTANTS LLC

MEDICARE: CAROLINA REHAB CONSULTANTS 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
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1386358877
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROLINA REHAB CONSULTANTS LLC
Provider Business Mailing Address
First Line : 2509A LEWISVILLE CLEMMONS RD # 1006
Second Line :
City : CLEMMONS
State : NC
Zip : 27012-8712
Country : US
Telephone Number : 336-298-2017
Fax Number :
Provider Business Practice Location Address
First Line : 2475 HILLCREST CENTER CIR
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-3048
Country : US
Telephone Number : 336-754-3500
Fax Number : 336-754-3895
Authorized Official
Title or Position : OWNER
Name : PATRICK CLEGG
Credential :
Telephone Number : 336-298-2017
Provider Enumeration Date : 01/09/2023
Last Update Date : 04/09/2025

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