Provider Demographics
NPI:1942063466
Name:ARCHITECH SPORTS AND PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:ARCHITECH SPORTS AND PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TYSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:704-900-8960
Mailing Address - Street 1:8918 BLAKENEY PROFESSIONAL DR STE 120
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6692
Mailing Address - Country:US
Mailing Address - Phone:704-900-8960
Mailing Address - Fax:704-817-9523
Practice Address - Street 1:11010 MONROE RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-8517
Practice Address - Country:US
Practice Address - Phone:704-900-8960
Practice Address - Fax:704-817-9523
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARCHITECH SPORTS AND PHYSICAL THERAPY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic