MEDICARE: PHOENIX PHYSICAL THERAPY & SPORTS PERFORMANCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	9701	NC

General Provider Information

NPI Number	:	1861555278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX PHYSICAL THERAPY & SPORTS PERFORMANCE

Provider Business Mailing Address
First Line	:	290 N NC 16 BUSINESS HWY
Second Line	:
City	:	DENVER
State	:	NC
Zip	:	28037-8011
Country	:	US
Telephone Number	:	704-483-0777
Fax Number	:	704-483-1883

Provider Business Practice Location Address
First Line	:	290 N HIGHWAY 16
Second Line	:
City	:	DENVER
State	:	NC
Zip	:	28037-8011
Country	:	US
Telephone Number	:	704-483-0777
Fax Number	:	704-483-1883

Authorized Official
Title or Position	:	OWNER
Name	:	TATUM F ROBINSON
Credential	:	DPT
Telephone Number	:	704-483-0777

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	09/03/2025

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Directions to “PHOENIX PHYSICAL THERAPY & SPORTS PERFORMANCE ” Practice Location

Language	Start Address	Practice Location

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