Healthcare Provider Details

I. General information

NPI: 1235936253
Provider Name (Legal Business Name): JOHN PATRICK DUFFY DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 BRIDGEMILL DR STE 106
FORT MILL SC
29707-9211
US

IV. Provider business mailing address

2020 W MOREHEAD ST APT 207
CHARLOTTE NC
28208-5834
US

V. Phone/Fax

Practice location:
  • Phone: 803-298-8995
  • Fax: 803-620-4670
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12848
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP23922
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: