Healthcare Provider Details

I. General information

NPI: 1942329925
Provider Name (Legal Business Name): TIMOTHY R. MERTZ PHYSICAL THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7277 NC HIGHWAY 42W 208
RALEIGH NC
27603-7528
US

IV. Provider business mailing address

1620 KENDALL HILL RD
WILLOW SPRING NC
27592-9069
US

V. Phone/Fax

Practice location:
  • Phone: 919-773-4086
  • Fax: 919-773-4087
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberP14288
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: