MEDICARE: REHAB CENTER INC

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	225400000X	Rehabilitation Practitioner		NC

General Provider Information

NPI Number	:	1912986993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB CENTER INC

Provider Business Mailing Address
First Line	:	2610 E 7TH ST
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-4375
Country	:	US
Telephone Number	:	704-375-8900
Fax Number	:	704-335-7178

Provider Business Practice Location Address
First Line	:	2610 E 7TH ST
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-4375
Country	:	US
Telephone Number	:	704-375-8900
Fax Number	:	704-335-7178

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. WALTER BRIAN O'MALLEY
Credential	:	PHD
Telephone Number	:	704-375-8900

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	10/04/2012

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