Healthcare Provider Details

I. General information

NPI: 1073465605
Provider Name (Legal Business Name): MIKAYLA HENDRIX FOX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MIKAYLA FOX

II. Dates (important events)

Enumeration Date: 02/14/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 CABARRUS AVE W
CONCORD NC
28025-5150
US

IV. Provider business mailing address

402 WALKER ST
KANNAPOLIS NC
28081-5424
US

V. Phone/Fax

Practice location:
  • Phone: 704-239-6321
  • Fax:
Mailing address:
  • Phone: 864-414-4934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP24757
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: