Healthcare Provider Details

I. General information

NPI: 1447906078
Provider Name (Legal Business Name): DYNAMIC KIDS PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 PEBBLE BEACH DR
HAMPSTEAD NC
28443-8050
US

IV. Provider business mailing address

129 PEBBLE BEACH DR
HAMPSTEAD NC
28443-8050
US

V. Phone/Fax

Practice location:
  • Phone: 585-203-2492
  • Fax:
Mailing address:
  • Phone: 585-203-2492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLAIRE GUY
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 585-203-2492