Healthcare Provider Details

I. General information

NPI: 1225633316
Provider Name (Legal Business Name): BRIANNA LYN FARRAR PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIANNA L DOWLER DPT

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 12/04/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 GUERNSEY ST
BELLAIRE OH
43906-1540
US

IV. Provider business mailing address

1 MEDICAL PARK BUSINESS OFFICE - NTTC - CREDENTIALING
WHEELING WV
26003-6379
US

V. Phone/Fax

Practice location:
  • Phone: 740-676-4623
  • Fax: 740-671-6333
Mailing address:
  • Phone: 304-243-3124
  • Fax: 304-243-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT014930
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: