Provider Demographics
NPI:1992938823
Name:CAROLINA SPINE CENTER PA
Entity type:Organization
Organization Name:CAROLINA SPINE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:UNDERWOOD
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-997-3733
Mailing Address - Street 1:PO BOX 828
Mailing Address - Street 2:
Mailing Address - City:HAMLET
Mailing Address - State:NC
Mailing Address - Zip Code:28345-0828
Mailing Address - Country:US
Mailing Address - Phone:910-997-3733
Mailing Address - Fax:910-997-3707
Practice Address - Street 1:120 COUNTY HOME ROAD
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379
Practice Address - Country:US
Practice Address - Phone:910-997-3733
Practice Address - Fax:910-997-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-00719208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty