Organization
PHOENIX PHYSICAL THERAPY AND SPORTS PERFORMANCE -LAKE NORMAN
Active
Parent organization
PHOENIX PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC
Authorized official
JOSHUA D VAUGHAN DPT (MANAGING MEMBER)
(704) 483-0777
Entity
Organization
Contact information
Practice address
7825 NC HIGHWAY 150 E STE 6, TERRELL, NC 28682-8703
(704) 483-0777
(704) 483-1883
Mailing address
290 N HIGHWAY 16, DENVER, NC 28037-8011
(704) 483-0777
(704) 483-1883
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
P14807
NC
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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