Provider Demographics
NPI:1235715525
Name:PROHEAL NC INC
Entity Type:Organization
Organization Name:PROHEAL NC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE REP
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCHNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-789-3227
Mailing Address - Street 1:434 N TRADE ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-1864
Mailing Address - Country:US
Mailing Address - Phone:704-345-8507
Mailing Address - Fax:704-234-7878
Practice Address - Street 1:434 N TRADE ST STE 203
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-1864
Practice Address - Country:US
Practice Address - Phone:704-345-8507
Practice Address - Fax:704-234-7878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty