MEDICARE: CARESOUTH REHAB

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	2761	SC

General Provider Information

NPI Number	:	1821366659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARESOUTH REHAB

Provider Business Mailing Address
First Line	:	11 EASLEY BRIDGE RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-5110
Country	:	US
Telephone Number	:	864-907-5329
Fax Number	:	864-292-5338

Provider Business Practice Location Address
First Line	:	11 EASLEY BRIDGE RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-5110
Country	:	US
Telephone Number	:	864-907-5329
Fax Number	:	864-292-5338

Authorized Official
Title or Position	:	DPT
Name	:	DR. AHMED M ABDELADL
Credential	:	DPT
Telephone Number	:	864-907-5329

Provider Enumeration Date	:	12/07/2011
Last Update Date	:	12/07/2011

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Directions to “CARESOUTH REHAB ” Practice Location

Language	Start Address	Practice Location

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