Healthcare Provider Details

I. General information

NPI: 1396743134
Provider Name (Legal Business Name): MARC CHRISTOPHER BREWER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 GLEN ESTE WITHAMSVILLE RD SUITE 500
CINCINNATI OH
45245-1318
US

IV. Provider business mailing address

4440 GLEN ESTE WITHAMSVILLE RD SUITE 500
CINCINNATI OH
45245-1318
US

V. Phone/Fax

Practice location:
  • Phone: 513-794-3363
  • Fax: 513-753-4308
Mailing address:
  • Phone: 513-794-3363
  • Fax: 513-753-4308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-09206
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: