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NPI Code Detail

MEDICARE: BRYAN CHEDDAR DPT

MEDICARE: BRYAN CHEDDAR DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT32077FL

General Provider Information

NPI Number : 1245782481
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN CHEDDAR DPT
Provider Business Mailing Address
First Line : 6050 PEACHTREE PKWY STE 410
Second Line :
City : NORCROSS
State : GA
Zip : 30092-3337
Country : US
Telephone Number : 770-441-1276
Fax Number : 770-441-1278
Provider Business Practice Location Address
First Line : 4714 OKEECHOBEE BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33417-4626
Country : US
Telephone Number : 561-432-0111
Fax Number : 561-432-1075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2016
Last Update Date : 07/07/2021

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Directions to “ BRYAN CHEDDAR DPT” Practice Location

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