Provider Demographics
NPI:1063665263
Name:ORTHOCAROLINA
Entity type:Organization
Organization Name:ORTHOCAROLINA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANNIEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:MURREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-323-2010
Mailing Address - Street 1:4601 PARK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3239
Mailing Address - Country:US
Mailing Address - Phone:704-323-2256
Mailing Address - Fax:704-323-3911
Practice Address - Street 1:15825 JOHN J DELANEY DR
Practice Address - Street 2:SUITE 140
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3146
Practice Address - Country:US
Practice Address - Phone:704-323-3278
Practice Address - Fax:704-341-5269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38865225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty