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

Ethan Mix, DPT

Individual provider Physical Therapist · NPI 1295108090

Ethan Mix, DPT is a Physical Therapist in Charlotte, North Carolina. Works from 3 locations. Licensed in North Carolina and New York.

Licensed in
NC, NY
In the registry since
2015
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

445 S Kings Dr
Charlotte, NC 28204-3041
Phone: (704) 384-1737
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 10810 Mallard Creek Rd, Charlotte, NC 28262-9786 — (704) 510-8000
  • 92 West Ave, Brockport, NY 14420-1306 — (585) 637-0790

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence P17497 (NC)
Physical Therapist Taxonomy 225100000X · Licence 039525-1 (NY)

Record details

NPI number1295108090
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedNovember 3, 2015
Last updated in NPPESFebruary 24, 2021
Certification dateFebruary 24, 2021

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