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Organization
ACTIVEDGE FITNESS AND SPORTS PERFORMANCE, INC.
Active
Organization
ACTIVEDGE FITNESS AND SPORTS PERFORMANCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN DAVID DIAZ MPT (OWNER)
(919) 493-1204
Entity
Organization
Contact information
Practice address
4221 GARRETT RD, SUITE 1-2, DURHAM, NC 27707-3467
(919) 493-1204
(919) 493-1204
Mailing address
4221 GARRETT RD, SUITE 1-2, DURHAM, NC 27707-3467
(919) 493-1204
(919) 493-1204
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
8453
NC
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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