MEDICARE: ERIC VINCENT BRAUN MPT

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
1	225100000X	Physical Therapist	PT-009117 L	PA

General Provider Information

NPI Number	:	1255331930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC VINCENT BRAUN MPT

Provider Business Mailing Address
First Line	:	352 BROOK DR
Second Line	:
City	:	SPRING CITY
State	:	PA
Zip	:	19475-2501
Country	:	US
Telephone Number	:	484-984-0226
Fax Number	:

Provider Business Practice Location Address
First Line	:	341 10TH AVE
Second Line	:	SUITE 101
City	:	ROYERSFORD
State	:	PA
Zip	:	19468-3806
Country	:	US
Telephone Number	:	610-792-8100
Fax Number	:	610-792-1535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	05/20/2022

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