# ULTRA SPORTS PERFORMANCE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376309351
- **Authorized official:** DR. KYLAH GEORGE PT, DPT (PHYSICAL THERAPIST)
- **Authorized official phone:** (704) 524-8165

## Contact information

- **Practice address:** 7733 BALLANTYNE COMMONS PKWY STE 103, CHARLOTTE, NC 28277-4398
- **Practice address phone:** (704) 236-0222
- **Mailing address:** 7733 BALLANTYNE COMMONS PKWY STE 103, CHARLOTTE, NC 28277-4398
- **Mailing address phone:** (704) 236-0222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/26/2024
- **Last updated:** 07/07/2024