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General NPI Number Information
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NPI Number | 1154093201
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Entity Type | Individual
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Provider Name | CORAL N BREUNING DPT
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Gender | Female
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Dates
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Enumeration Date | 09/28/2021
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Last Update Date | 11/26/2023
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Provider Practice Location Address
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Address Line | 7280 FRENCHMAN BAY
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City | CHARLOTTE AMALIE
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State | VI
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Zip | 00802
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Country | US
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Telephone | 340-642-5602
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Fax |
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Provider Business Mailing Address
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Address Line | 7280 FRENCHMAN BAY
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City | ST THOMAS
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State | VI
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Zip | 00802-2809
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Country | US
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Telephone | 340-514-2376
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 25582
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 290
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License Number State | VI
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