# CAROLINA PRIME PHYSICAL THERAPY

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

## Provider details

- **NPI number:** 1902392418
- **Authorized official:** MR. SCOTT FORREST PT COMT (OWNER)
- **Authorized official phone:** (336) 990-1028

## Contact information

- **Practice address:** 200 W PARK CIR STE A, NORTH WILKESBORO, NC 28659-3583
- **Practice address phone:** (336) 818-2700
- **Practice address fax:** (336) 450-1700
- **Mailing address:** 343 FOREST GLEN LN, WILKESBORO, NC 28697-7000
- **Mailing address phone:** (336) 990-1028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | P10047 | NC | — |
| 261QR0400X | Rehabilitation Clinic/Center | 8609 | NC | — |
| 261QR0400X | Rehabilitation Clinic/Center | P10047 | NC | — |

## Other

- **Enumeration date:** 07/09/2018
- **Last updated:** 08/20/2023