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NPI Code Detail

MEDICARE: MARK A BRAMMER JR. P.T.

MEDICARE: MARK A BRAMMER JR. P.T.
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 Therapist5501010998MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1650C913860OTHERMIBCBS

General Provider Information

NPI Number : 1265400444
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK A BRAMMER JR. P.T.
Provider Business Mailing Address
First Line : 8591 CROSSROADS DRIVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44514
Country : US
Telephone Number : 330-758-0577
Fax Number : 330-758-0466
Provider Business Practice Location Address
First Line : 1397 S CANFIELD NILES RD
Second Line : UNIT 1
City : AUSTINTOWN
State : OH
Zip : 44515-4084
Country : US
Telephone Number : 330-953-0129
Fax Number : 330-953-0650
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 12/06/2023

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