Healthcare Provider Details

I. General information

NPI: 1669679031
Provider Name (Legal Business Name): DOUGLAS V DEUSSING D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1591 YANCEYVILLE ST STE 400
GREENSBORO NC
27405-6945
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 336-274-7480
  • Fax: 336-274-8903
Mailing address:
  • Phone: 502-882-9379
  • Fax: 502-587-5728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP14320
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: