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General NPI Number Information
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NPI Number | 1700642469
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Entity Type | Organization
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Legal Business Name | USPC SPORTS MEDICINE LLC
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Dates
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Enumeration Date | 02/21/2024
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 9319 ROBERT D. SNYDER RD SUITE 418
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City | CHARLOTTE
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State | NC
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Zip | 28223
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Country | US
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Telephone | 980-395-9091
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Fax |
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Provider Business Mailing Address
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Address Line | 9319 ROBERT D. SNYDER RD SUITE 416
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City | CHARLOTTE
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State | NC
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Zip | 28223
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Country | US
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Telephone | 980-395-9091
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | IRWIN BELK
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Credential |
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Telephone | 980-257-0771
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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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