MEDICARE: JACLYN ROSE MONACO

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	225100000X	Physical Therapist	P24708	NC

General Provider Information

NPI Number	:	1558227397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACLYN ROSE MONACO

Provider Business Mailing Address
First Line	:	901 BERRYHILL RD STE I
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-4115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 BERRYHILL RD STE I
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-4115
Country	:	US
Telephone Number	:	980-890-3244
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/24/2025
Last Update Date	:	02/16/2026

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Directions to “ JACLYN ROSE MONACO ” Practice Location

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