Basic Information
Provider Information
NPI: 1952346439
EntityType: 2
ReplacementNPI:  
OrganizationName: CAROLINA PHYSICAL THERAPY SPECIALISTS, INC
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Mailing Information
Address1: 905B OLD WINSTON RD
Address2:  
City: KERNERSVILLE
State: NC
PostalCode: 272848120
CountryCode: US
TelephoneNumber: 3369922787
FaxNumber: 3369939943
Practice Location
Address1: 905B OLD WINSTON RD
Address2:  
City: KERNERSVILLE
State: NC
PostalCode: 272848120
CountryCode: US
TelephoneNumber: 3369922787
FaxNumber: 3369939943
Other Information
ProviderEnumerationDate: 06/18/2006
LastUpdateDate: 10/27/2009
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AuthorizedOfficialLastName: HOWARD
AuthorizedOfficialFirstName: RALPH
AuthorizedOfficialMiddleName: LEON
AuthorizedOfficialTitleorPosition: PRESIDENT/CEO
AuthorizedOfficialTelephone: 3369922787
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix: JR.
AuthorizedOfficialCredential: PHD, PT
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X6408NCY193400000X SINGLE SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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