MEDICARE: MR. JOEY POK SI YIP PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0397730017	OTHER	NC	NSC #

General Provider Information

NPI Number	:	1295464493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOEY POK SI YIP PT

Provider Business Mailing Address
First Line	:	4700 LEBANON RD STE D2
Second Line	:
City	:	MINT HILL
State	:	NC
Zip	:	28227-8265
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 LEBANON RD STE D2
Second Line	:
City	:	MINT HILL
State	:	NC
Zip	:	28227-8265
Country	:	US
Telephone Number	:	704-817-7963
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2022
Last Update Date	:	03/14/2026

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