# CAROLINA PHYSICAL MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619413820
- **Authorized official:** ANTHONY HYSER DC (MANAGER)
- **Authorized official phone:** (704) 800-7414

## Contact information

- **Practice address:** 6911 SHANNON WILLOW RD, SUITE 500, CHARLOTTE, NC 28226-1346
- **Practice address phone:** (704) 800-7414
- **Practice address fax:** (704) 817-3390
- **Mailing address:** 6911 SHANNON WILLOW RD, SUITE 500, CHARLOTTE, NC 28226-1346
- **Mailing address phone:** (704) 800-7414
- **Mailing address fax:** (704) 817-3390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/11/2017
- **Last updated:** 10/13/2017