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General NPI Number Information
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NPI Number | 1104779255
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Entity Type | Organization
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Legal Business Name | LEGACY PHYSICAL THERAPY AND PERFORMANCE, LLC
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 9061 SR-14
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City | STREETSBORO
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State | OH
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Zip | 44241
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Country | US
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Telephone | 216-452-8606
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Fax |
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Provider Business Mailing Address
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Address Line | 8007 DOVEGATE CIR
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City | MENTOR
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State | OH
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Zip | 44060-5997
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Country | US
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Telephone | 813-230-9328
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | DAVID COLVIN
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Credential | PT, DPT, ATC
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Telephone | 813-230-9328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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