Healthcare Provider Details

I. General information

NPI: 1891327029
Provider Name (Legal Business Name): BRIANNA HURT PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6851 OAK HALL LN STE 102
COLUMBIA MD
21045-5815
US

IV. Provider business mailing address

6851 OAK HALL LN STE 102
COLUMBIA MD
21045-5815
US

V. Phone/Fax

Practice location:
  • Phone: 443-979-7123
  • Fax: 443-979-7625
Mailing address:
  • Phone: 443-979-7123
  • Fax: 443-979-7625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT872607
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305213406
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number28816
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: