Provider Demographics
NPI:1982393179
Name:CAROLINA PHYSICIANS AND REHAB, LLC
Entity Type:Organization
Organization Name:CAROLINA PHYSICIANS AND REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:KELBY
Authorized Official - Last Name:HUTCHESON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-699-4188
Mailing Address - Street 1:PO BOX 26838
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29616-1838
Mailing Address - Country:US
Mailing Address - Phone:888-699-4188
Mailing Address - Fax:864-335-9252
Practice Address - Street 1:279 E KENNEDY ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-1912
Practice Address - Country:US
Practice Address - Phone:888-699-4188
Practice Address - Fax:864-335-9252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty