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Organization

PROVIDENCE PHYSICAL MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RACHEL HYSER (OFFICE MANAGER)
(704) 620-8857
Entity
Organization

Contact information

Practice address
6911 SHANNON WILLOW RD, STE 500, CHARLOTTE, NC 28226-1346
(704) 800-7414
Mailing address
6911 SHANNON WILLOW RD, STE 500, CHARLOTTE, NC 28226-1346
(704) 800-7414

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2006-01409
NC

Other

Enumeration date
07/11/2016
Last updated
07/11/2016
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