Organization
BRIDDELL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK ANTONIO BRIDDELL PT, DSC, MS, SCS (OWNER/PHYSICAL THERAPIST)
(410) 251-4467
Entity
Organization
Contact information
Practice address
1666 WIMBLEDON DR, APT 204, GREENVILLE, NC 27858-5392
(410) 251-4467
Mailing address
PO BOX 1651, GREENVILLE, NC 27835-1651
(410) 251-4467
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
11098
NC
261QP2000X
Physical Therapy Clinic/Center
17958
MD
261QP2000X
Physical Therapy Clinic/Center
5297
SC
261QP2000X
Physical Therapy Clinic/Center
J1-0001697
DE
Other
Enumeration date
06/30/2005
Last updated
08/17/2007
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