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Organization

WAKE FOREST PHYSICAL THERAPY

Active
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Organization

WAKE FOREST PHYSICAL THERAPY

Active
Other names
Elite Ortho Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
JASEN BRISSON (OWNER)
(919) 570-7080
Entity
Organization

Contact information

Practice address
843 WAKE FOREST BUSINESS PARK, SUITE 110, WAKE FOREST, NC 27587-6577
(919) 570-7080
(919) 570-7081
Mailing address
843 WAKE FOREST BUSINESS PARK, SUITE 110, WAKE FOREST, NC 27587-6577
(919) 570-7080
(919) 570-7081

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101957600
DEPT. LABOR WORKERS COMP
NC
01
—
1112Q
BLUE CROSS BLUE SHIELD
NC
01
—
7659542
AETNA
NC
01
—
C6034
MEDCOST
NC
Enumeration date
05/08/2006
Last updated
11/17/2025
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