Healthcare Provider Details

I. General information

NPI: 1841946910
Provider Name (Legal Business Name): BRYAN FORD DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2022
Last Update Date: 02/26/2022
Certification Date: 02/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38069 TOWN CENTER DR UNIT 15
MILLVILLE DE
19967-6968
US

IV. Provider business mailing address

659 S SALISBURY BLVD STE 1B
SALISBURY MD
21801-5458
US

V. Phone/Fax

Practice location:
  • Phone: 302-539-3110
  • Fax: 302-539-7237
Mailing address:
  • Phone: 410-831-3226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0014516
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: