Individual
MR. BRIAN RICHARD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
8410 LOUISBURG RD STE 130, RALEIGH, NC 27616
(919) 514-3177
(919) 939-2353
Mailing address
350 NEW FIDELITY CT, GARNER, NC 27529-2665
(919) 756-3107
(919) 535-3271
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P16466
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31305-4
BLUE CROSS
RI
01
—
413289
BLUE CHIP
RI
01
—
PT02015
STATE LICENSE NUMBER
RI
Enumeration date
05/24/2006
Last updated
05/31/2018
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