Healthcare Provider Details

I. General information

NPI: 1922549088
Provider Name (Legal Business Name): BRETT MATTHEW AEFSKY PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2017
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 WHITFORD DR
DURHAM NC
27710-0001
US

IV. Provider business mailing address

923 DEMERIUS ST
DURHAM NC
27701-1505
US

V. Phone/Fax

Practice location:
  • Phone: 703-580-6823
  • Fax:
Mailing address:
  • Phone: 703-508-6823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberP13771
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: