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General NPI Number Information
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NPI Number | 1861349284
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Entity Type | Organization
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Legal Business Name | TYSON REHAB AND PERFORMANCE, LLC
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 718 GESCO ST APT 234
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City | CHARLOTTE
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State | NC
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Zip | 28208-4377
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Country | US
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Telephone | 716-535-9409
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Fax |
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Provider Business Mailing Address
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Address Line | 718 GESCO ST APT 234
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City | CHARLOTTE
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State | NC
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Zip | 28208-4377
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Country | US
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Telephone | 716-535-9409
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, OWNER
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Name | DR. JOSHUA KEITH TYSON
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Credential | PT, DPT, CSCS
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Telephone | 716-535-9409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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