Provider Demographics
NPI:1952658833
Name:CAMPBELL, BRIAN SCOTT (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:SCOTT
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14460 FALLS OF NEUSE RD
Mailing Address - Street 2:SUITE 149-168
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8227
Mailing Address - Country:US
Mailing Address - Phone:919-473-6165
Mailing Address - Fax:
Practice Address - Street 1:13200 STRICKLAND RD
Practice Address - Street 2:SUITE 116
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-5212
Practice Address - Country:US
Practice Address - Phone:919-473-6165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1221156225100000X
NCP153622251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist