Basic Information
| Provider Information | |||||||||
| NPI: | 1205280781 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARRETT | ||||||||
| FirstName: | BRANDY | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 HIGH RISE | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402133202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5029664466 | ||||||||
| FaxNumber: | 5029643271 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 HIGH RISE | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402133202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5029664466 | ||||||||
| FaxNumber: | 5029643271 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2016 | ||||||||
| LastUpdateDate: | 04/20/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 004895 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.