Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Physical Therapy & Performance, LLC

Organization Physical Therapy Clinic/Center · NPI 1104279520

Providence Physical Therapy & Performance, LLC is a Physical Therapy Clinic/Center in Tabor City, North Carolina. Licensed in North Carolina. Registered with an NPI since 2016.

Licensed in
NC
In the registry since
2016
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

107 Live Oak St
Tabor City, NC 28463-2042
Phone: (252) 916-9949
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X · Licence 10244 (NC)

Record details

NPI number1104279520
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Bullard — Physical Therapist/Owner/Manager · (252) 916-9949
NPI enumeratedJuly 20, 2016
Last updated in NPPESFebruary 6, 2017
Mailing addressPo Box 219, Tabor City, NC 28463-0219