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NPI Code Detail

MEDICARE: NORTH CAROLINA INSTITUTE OF SPORTS BIOMECHANICS, LLC

MEDICARE: NORTH CAROLINA INSTITUTE OF SPORTS BIOMECHANICS, 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
1261QP2000XPhysical Therapy Clinic/Center9857NC

General Provider Information

NPI Number : 1780090324
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH CAROLINA INSTITUTE OF SPORTS BIOMECHANICS, LLC
Provider Business Mailing Address
First Line : 2428 STEWART ST
Second Line :
City : FUQUAY VARINA
State : NC
Zip : 27526-8995
Country : US
Telephone Number : 919-372-8412
Fax Number :
Provider Business Practice Location Address
First Line : 2121 E WILLIAMS ST
Second Line : SUITE 108
City : APEX
State : NC
Zip : 27539-7764
Country : US
Telephone Number : 919-946-7011
Fax Number :
Authorized Official
Title or Position : CO-OWNER/PHYSICAL THERAPIST
Name : LEE M WELCH
Credential :
Telephone Number : 919-372-8412
Provider Enumeration Date : 07/03/2014
Last Update Date : 02/22/2022

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Directions to “NORTH CAROLINA INSTITUTE OF SPORTS BIOMECHANICS, LLC ” Practice Location

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