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General NPI Number Information
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NPI Number | 1215724901
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Entity Type | Organization
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Legal Business Name | FORTRESS PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 10000 PINEVILLE MATTHEWS RD
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City | PINEVILLE
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State | NC
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Zip | 28134-7552
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Country | US
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Telephone | 980-272-8044
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 PINEVILLE MATTHEWS RD
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City | PINEVILLE
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State | NC
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Zip | 28134-7552
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Country | US
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Telephone | 980-272-8044
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. AMY N BULLOCK
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Credential | PT, DPT
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Telephone | 304-374-7228
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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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