MEDICARE: PRO REHAB NOW

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	376K00000X	Nurse's Aide
2	376J00000X	Homemaker
3	225100000X	Physical Therapist
4	225X00000X	Occupational Therapist
5	3747P1801X	Personal Care Attendant
6	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1427668227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO REHAB NOW

Provider Business Mailing Address
First Line	:	9716 REA RD
Second Line	:	STE B PBM 1025
City	:	MINT HILL
State	:	NC
Zip	:	28277-9305
Country	:	US
Telephone Number	:	980-288-6225
Fax Number	:	704-285-2311

Provider Business Practice Location Address
First Line	:	9716 REA RD
Second Line	:	STE B PBM 1025
City	:	MINT HILL
State	:	NC
Zip	:	28277-9305
Country	:	US
Telephone Number	:	980-288-6225
Fax Number	:	704-285-2311

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST/OWNER
Name	:	MRS. VONDA CRISWELL
Credential	:	MA,CCC-SLP
Telephone Number	:	980-288-6225

Provider Enumeration Date	:	08/06/2020
Last Update Date	:	09/24/2020

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Directions to “PRO REHAB NOW ” Practice Location

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