Provider Demographics
NPI:1902991011
Name:PRO MOTION REHAB, INC.
Entity type:Organization
Organization Name:PRO MOTION REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VEROLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-837-0400
Mailing Address - Street 1:2810 W US HIGHWAY 64 STE 1
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-4061
Mailing Address - Country:US
Mailing Address - Phone:828-837-4000
Mailing Address - Fax:828-837-0404
Practice Address - Street 1:2810 W US HIGHWAY 64 STE 1
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-4061
Practice Address - Country:US
Practice Address - Phone:828-837-4000
Practice Address - Fax:828-837-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7212819Medicaid
NC7212819Medicaid
NC6250400001Medicare NSC