Provider Demographics
NPI:1912178393
Name:REHAB CLINICS OF NORTH CAROLINA, P.A.
Entity type:Organization
Organization Name:REHAB CLINICS OF NORTH CAROLINA, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNUNZIATA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-338-1838
Mailing Address - Street 1:2505 S 17TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7705
Mailing Address - Country:US
Mailing Address - Phone:910-791-1900
Mailing Address - Fax:
Practice Address - Street 1:2505 S 17TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7705
Practice Address - Country:US
Practice Address - Phone:910-791-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCH3836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty