# ORTHO SPORT & SPINE PHYSICIANS FORT MILL

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

## Provider details

- **NPI number:** 1386338275
- **Authorized official:** FAITH A BELTZHOOVER (RCM DIRECTOR)
- **Authorized official phone:** (678) 752-7246

## Contact information

- **Practice address:** 1698 HIGHWAY 160 W, FORT MILL, SC 29708-8032
- **Practice address phone:** (678) 752-7246
- **Mailing address:** 5788 ROSWELL RD, ATLANTA, GA 30328-4904
- **Mailing address phone:** (678) 752-7246

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/05/2023
- **Last updated:** 06/05/2023