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General NPI Number Information
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NPI Number | 1962312637
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Entity Type | Organization
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Legal Business Name | AXIS SPORTS PERFORMANCE & REHAB PLLC
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 941 WATERLICK RD UNIT 2-7
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City | LYNCHBURG
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State | VA
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Zip | 24501-7222
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Country | US
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Telephone | 434-363-0568
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Fax |
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Provider Business Mailing Address
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Address Line | 941 WATERLICK RD UNIT 2-7
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City | LYNCHBURG
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State | VA
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Zip | 24501-7222
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Country | US
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Telephone | 434-363-0568
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. AUSTIN H BENNETT
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Credential | DPT
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Telephone | 434-363-0568
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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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