Organization
COMPREHENSIVE REHABILITATION & PAIN SPECIALISTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA L. FULLER-HINES M.D. (PRESIDENT)
(215) 287-2738
Entity
Organization
Contact information
Practice address
135 E RICH BLVD, ELIZABETH CITY, NC 27909-5518
(252) 333-1277
(252) 333-1877
Mailing address
135 E RICH BLVD, ELIZABETH CITY, NC 27909-5518
(215) 287-2738
(252) 335-2840
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2007-00519
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019WY
BCBS
—
05
—
5908742
—
NC
Enumeration date
12/20/2007
Last updated
06/10/2013
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