PROVIDENCE PHYSICAL THERAPY & PERFORMANCE, LLC.
NPI 1104279520
Clinic/Center - Physical Therapy in Tabor City, NC

Active since July 20, 2016
107 LIVE OAK ST, TABOR CITY, NC 28463(252) 916-9949 Get Directions Write a Review

NPPES record last updated: February 6, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 6, 2017, Feb 3, 2017 (2 updates tracked since 2017).

About Providence Physical Therapy & Performance, Llc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE PHYSICAL THERAPY & PERFORMANCE, LLC. (NPI 1104279520) is a healthcare organization registered as a physical therapy in Tabor City, North Carolina and active in the NPI registry since July 2016. The organization lists Kevin Brian Bullard, Physical Therapist/owner/manager, as its authorized official.

NPPES Registry Identity

NPI1104279520
Entity TypeOrganization
Primary Taxonomy261QP2000X
Legal Business NamePROVIDENCE PHYSICAL THERAPY & PERFORMANCE, LLC.
Location Address107 LIVE OAK STTabor City, NC 28463-2042
Mailing AddressPo Box 219Tabor City, NC 28463-0219 · (910) 377-3146 · Fax (910) 377-3277
Organization SubpartNo
Authorized OfficialKevin Brian BullardPhysical Therapist/owner/manager · (252) 916-9949
Enumeration DateJuly 20, 2016
Last NPPES UpdateFebruary 6, 20172 updates tracked since enumeration
NPI 1104279520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Physical TherapyAmbulatory Health Care Facilities
Taxonomy Code261QP2000X
License Licensed in NC · 10244
Definition
An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.
107 LIVE OAK ST, Tabor City, NC 28463

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
107 LIVE OAK ST, STE C
TABOR CITY, NC 28463

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Physical Therapy & Performance, LLC.'s NPI number?

The NPI number for Providence Physical Therapy & Performance, LLC. is 1104279520. It was assigned to this organization in the NPPES registry on July 20, 2016.

Where is Providence Physical Therapy & Performance, LLC. located?

Providence Physical Therapy & Performance, LLC. is located at 107 Live Oak St, Tabor City, NC 28463. The listed phone number is (252) 916-9949.

What is Providence Physical Therapy & Performance, LLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Physical Therapy, with taxonomy code 261QP2000X.

When was this NPI record last updated?

The NPPES record for Providence Physical Therapy & Performance, LLC. was last updated on February 6, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.