Basic Information
| Provider Information | |||||||||
| NPI: | 1770035990 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MUSSARD | ||||||||
| FirstName: | BRIANNE | ||||||||
| MiddleName: | |||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2854 BELL ST | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437011721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404543273 | ||||||||
| FaxNumber: | 7405881081 | ||||||||
| Practice Location | |||||||||
| Address1: | 2854 BELL ST | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437011721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404543273 | ||||||||
| FaxNumber: | 7405881081 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2016 | ||||||||
| LastUpdateDate: | 11/04/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | PT016122 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.