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NPI Code Detail

MEDICARE: TYLER BRUNETTI

MEDICARE:   TYLER  BRUNETTI
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
1225200000XPhysical Therapy Assistant011225OH

General Provider Information

NPI Number : 1609484765
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER BRUNETTI
Provider Business Mailing Address
First Line : 1515 BETHEL RD STE 301
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-2056
Country : US
Telephone Number : 740-953-1184
Fax Number :
Provider Business Practice Location Address
First Line : 1515 BETHEL RD STE 301
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-2056
Country : US
Telephone Number : 740-953-1184
Fax Number : 614-702-7226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2020
Last Update Date : 07/15/2020

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Directions to “ TYLER BRUNETTI ” Practice Location

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