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General NPI Number Information
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NPI Number | 1861555278
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Entity Type | Organization
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Legal Business Name | PHOENIX PHYSICAL THERAPY & SPORTS PERFORMANCE
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 290 N HIGHWAY 16
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City | DENVER
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State | NC
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Zip | 28037-8011
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Country | US
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Telephone | 704-483-0777
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Fax | 704-483-1883
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Provider Business Mailing Address
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Address Line | 290 N NC 16 BUSINESS HWY
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City | DENVER
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State | NC
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Zip | 28037-8011
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Country | US
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Telephone | 704-483-0777
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Fax | 704-483-1883
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Authorized Official
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Title or Position | OWNER
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Name | TATUM F ROBINSON
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Credential | DPT
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Telephone | 704-483-0777
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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 | 9701
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License Number State | NC
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