Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | 4654 | SC |
N | 225100000X | Physical Therapist | 4654 | SC |
N | 2251S0007X | Physical Therapist - Sports | 4654 | SC |
Y | 2251X0800X | Physical Therapist - Orthopedic | 4654 | SC |
NPI | 1912098401 |
---|---|
Provider Name | Mr. David Eugene Bright |
First Address | Clemson, SC 29631-2621 |
Second Address | Clemson, SC 29631-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 27/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0007359616 | AETNA (01) | SC |
122490004505 | HUMANA (01) | SC |
P3851977 | OXFORD (01) | SC |
TH1876 | (05) | SC |