Healthcare Provider Details

I. General information

NPI: 1396653309
Provider Name (Legal Business Name): JOSHUA COPELAND PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 VILLAGE RD STE 102
SHALLOTTE NC
28470-3409
US

IV. Provider business mailing address

PO BOX 601791
CHARLOTTE NC
28260-1791
US

V. Phone/Fax

Practice location:
  • Phone: 910-721-3157
  • Fax: 910-754-5577
Mailing address:
  • Phone: 336-718-4820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP24075
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberP24075
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: