Provider Demographics
NPI:1659159143
Name:PITT, TYRONE EDWARD JR (DPT)
Entity Type:Individual
Prefix:DR
First Name:TYRONE
Middle Name:EDWARD
Last Name:PITT
Suffix:JR
Gender:M
Credentials:DPT
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Mailing Address - Street 1:136 CORPORATE PARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6960
Mailing Address - Country:US
Mailing Address - Phone:704-360-2796
Mailing Address - Fax:704-360-2798
Practice Address - Street 1:136 CORPORATE PARK DR STE A
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6960
Practice Address - Country:US
Practice Address - Phone:704-360-2796
Practice Address - Fax:704-360-2798
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCP223212081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine