National Provider Identifier Database

MOMENTUM SPORT SPINE PC
Health Service


Contact Information

MOMENTUM SPORT & SPINE, PC
424 ZIMMER RD
FORT MILL, SC29707
Phone: 980-253-6547
Fax:
Website:
Specialty Taxonomy Code
* Health Service 261QH0100X

* Indicates primary specialty

NPI Profile & details for MOMENTUM SPORT & SPINE, PC

NPI Number 1215824982
Legal business name
LBN
MOMENTUM SPORT & SPINE, PC
Authorized official BRADLEY WIEST - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/23/2025
Last updated 06/23/2025 - About 12 months ago
Sole proprietor1 Not specified
Identifiers 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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