Healthcare Provider Details

I. General information

NPI: 1750216388
Provider Name (Legal Business Name): STRONG ROOTS PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 FOUR LAKES DR
MATTHEWS NC
28105-1727
US

IV. Provider business mailing address

1915 COLONY LINE CT
CHARLOTTE NC
28210-4496
US

V. Phone/Fax

Practice location:
  • Phone: 380-289-7277
  • Fax:
Mailing address:
  • Phone: 380-289-7277
  • 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: CHELSEA CRIST
Title or Position: OWNER
Credential: PT, DPT
Phone: 380-289-7277