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General NPI Number Information
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NPI Number | 1073835765
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Entity Type | Organization
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Legal Business Name | GREG OTT'S CENTER FOR PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 449 N WENDOVER RD SUITE B
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City | CHARLOTTE
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State | NC
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Zip | 28211-1064
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Country | US
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Telephone | 704-366-7723
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Fax | 704-366-7724
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Provider Business Mailing Address
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Address Line | PO BOX 932184
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City | ATLANTA
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State | GA
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Zip | 31193-2184
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | AMANDA STREETER
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Credential |
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Telephone | 800-699-9395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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