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General NPI Number Information
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NPI Number | 1841152501
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Entity Type | Organization
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Legal Business Name | LEGACY SPORTS PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 7307 SANDSCOVE CT STE 11
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City | WINTER PARK
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State | FL
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Zip | 32792-5902
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Country | US
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Telephone | 407-536-8311
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Fax |
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Provider Business Mailing Address
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Address Line | 113 EASTWIND LN
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City | FERN PARK
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State | FL
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Zip | 32730-2911
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Country | US
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Telephone | 240-520-8307
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. CHRISTOPHER ROYSTER
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Credential | PT
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Telephone | 240-520-8307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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