A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Sports | 2251S0007X |
* Indicates primary specialty
| NPI Number | 1225260144 |
| Credentials | D.P.T. |
| Entity | Individual |
| Enumeration date | 08/11/2009 |
| Last updated | 06/09/2025 - About 12 months ago |
| Sole proprietor1 | Yes |
| Identifiers |
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| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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