| Fight Back Performance And Recovery, Llc | |
|
1200 E Morehead St Ste 190 Charlotte NC 28204-2946 | |
| (919) 619-8231 | |
| Not Available |
| Full Name | Fight Back Performance And Recovery, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1200 E Morehead St Ste 190, Charlotte, North Carolina |
| Authorized Official Name and Position | Katherine Alden Edwards (CO-OWNER, PHYSICAL THERAPIST) |
| Authorized Official Contact | 9802090656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fight Back Performance And Recovery, Llc 1200 E Morehead St Ste 190 Charlotte NC 28204-2946 Ph: (980) 209-0656 | Fight Back Performance And Recovery, Llc 1200 E Morehead St Ste 190 Charlotte NC 28204-2946 Ph: (919) 619-8231 |
| NPI Number | 1851867394 |
|---|---|
| Provider Enumeration Date | 10/23/2018 |
| Last Update Date | 05/01/2019 |
| Medicare PECOS PAC ID | 0446599294 |
|---|---|
| Medicare Enrollment ID | O20190222001176 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851867394 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Secondary |
| Provider Name | Donna D Short |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073940797 PECOS PAC ID: 3274768742 Enrollment ID: I20131109000172 |
| Provider Name | Katherine Alden Edwards |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265818744 PECOS PAC ID: 7911215710 Enrollment ID: I20150928002269 |
| Provider Name | Austin Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699290635 PECOS PAC ID: 5698040236 Enrollment ID: I20171006000707 |
| Provider Name | Andrea C Smisko |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841576063 PECOS PAC ID: 8123285319 Enrollment ID: I20191204002167 |
| Provider Name | Kathleen Kay Miller |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710977418 PECOS PAC ID: 6305739780 Enrollment ID: I20210201000457 |
| Provider Name | Jordan Spennato |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841892064 PECOS PAC ID: 8426408311 Enrollment ID: I20231218003999 |
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