Providence Physical Therapy & Performance, Llc.
NPI #1104279520 in Tabor City, North Carolina
Provider Information
- NPI Number
- 1104279520
- Entity Type
- Organization
- Organization Name
- Providence Physical Therapy & Performance, Llc.
- Primary Specialty
- Clinic/Center - Physical Therapy
- Enumeration Date
- Jul 20, 2016
- Last Updated
- Feb 6, 2017
Practice Location
- Address
- 107 LIVE OAK ST
- City
- Tabor City
- State
- North Carolina
- ZIP Code
- 28463-2042
- Phone
- (252) 916-9949
Authorized Official
- Name
- DR. KEVIN BRIAN BULLARD, DPT
- Title
- PHYSICAL THERAPIST/OWNER/MANAGER
- Phone
- (252) 916-9949
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Physical Therapy — Physical Therapy |
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