Healthcare Provider Details

I. General information

NPI: 1275451874
Provider Name (Legal Business Name): THE LAKES PHYSICAL THERAPY, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4355 NC HIGHWAY 211 STE D
WEST END NC
27376-8390
US

IV. Provider business mailing address

4355 NC HIGHWAY 211 STE D
WEST END NC
27376-8390
US

V. Phone/Fax

Practice location:
  • Phone: 910-400-5145
  • Fax: 910-400-5145
Mailing address:
  • Phone: 910-400-5145
  • Fax: 910-400-5145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL PAYNE
Title or Position: OWNER
Credential: DPT
Phone: 910-400-5145