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General NPI Number Information
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NPI Number | 1770203705
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Entity Type | Individual
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Provider Name | DENALI BROOKE TARA DUFORD DPT
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Gender | Female
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 200 OKATIE VILLAGE DR STE 105
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City | BLUFFTON
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State | SC
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Zip | 29909-7526
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Country | US
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Telephone | 843-706-2861
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Fax | 843-706-2864
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Provider Business Mailing Address
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Address Line | 2001 BUTTERFIELD RD STE 1600
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1211
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Country | US
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Telephone | 866-370-8206
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Fax | 517-435-3670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP034861T
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP018677T
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT61268007
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License Number State | WA
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