Healthcare Provider Details

I. General information

NPI: 1831977016
Provider Name (Legal Business Name): AMELIA GRACE RIZK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10635 PARK RD STE D
CHARLOTTE NC
28210-8408
US

IV. Provider business mailing address

600 PENNSYLVANIA AVE SE
WASHINGTON DC
20003-4316
US

V. Phone/Fax

Practice location:
  • Phone: 980-890-3233
  • Fax:
Mailing address:
  • Phone: 202-543-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number2305216106
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP25098
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT210002434
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: