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General NPI Number Information
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NPI Number | 1184439291
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Entity Type | Individual
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Provider Name | MICHAEL TODD ELWOOD
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Gender | Male
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 8918 BLAKENEY PROFESSIONAL DR
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City | CHARLOTTE
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State | NC
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Zip | 28277-6691
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Country | US
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Telephone | 704-900-8960
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Fax |
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Provider Business Mailing Address
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Address Line | 8918 BLAKENEY PROFESSIONAL DR STE 120
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City | CHARLOTTE
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State | NC
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Zip | 28277-6692
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Country | US
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Telephone | 704-900-8960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | P23833
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P23833
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License Number State | NC
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