Healthcare Provider Details

I. General information

NPI: 1467384487
Provider Name (Legal Business Name): JOHN BRENDAN ALBERTY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

876 FORDING ISLAND RD STE 2
BLUFFTON SC
29910-8677
US

IV. Provider business mailing address

3121 N MCGILL CREEK RD
ROCHEPORT MO
65279-9385
US

V. Phone/Fax

Practice location:
  • Phone: 843-507-8473
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2026023015
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP058371T
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: