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General NPI Number Information
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NPI Number | 1548292055
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Entity Type | Individual
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Provider Name | BRIAN K HOMAN P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 319 W LANDIS AVE
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City | VINELAND
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State | NJ
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Zip | 08360-8101
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Country | US
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Telephone | 856-395-4373
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Fax | 856-692-7423
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Provider Business Mailing Address
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Address Line | 532 SHETLAND CT
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City | SEWELL
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State | NJ
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Zip | 08080-2513
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Country | US
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Telephone | 856-345-4830
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Fax | 856-853-0769
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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 | 40QA00274100
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License Number State | NJ
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