Healthcare Provider Details

I. General information

NPI: 1114842630
Provider Name (Legal Business Name): CONNOR SYKES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11931 PLAZA DR
MURRELLS INLET SC
29576-9356
US

IV. Provider business mailing address

526 WILLIWOOD RD
FAYETTEVILLE NC
28311-2959
US

V. Phone/Fax

Practice location:
  • Phone: 843-357-4039
  • Fax:
Mailing address:
  • Phone: 910-988-0149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: