Organization
TRIANGLE SPINE & SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARI K KUNCHA MD (PRESIDENT)
(919) 335-0911
Entity
Organization
Contact information
Practice address
1051 PEMBERTON HILL RD, SUITE 102, APEX, NC 27502-4267
(919) 335-0911
(919) 362-6911
Mailing address
1051 PEMBERTON HILL RD, SUITE102, APEX, NC 27502-4267
(919) 335-0911
(919) 362-6911
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
200401089
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89138TJ
—
NC
Enumeration date
08/20/2008
Last updated
10/28/2008
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