Individual
BRIDGER PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
253 NEW MARKET CTR, BOONE, NC 28607-3993
(828) 386-1719
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 497-0005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P16769
NC
2251X0800X
Orthopedic Physical Therapist
3095297-8016
UT
Other
Enumeration date
07/19/2016
Last updated
01/15/2025
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