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NPI 1902620271

NPI 1902620271 : BRENNENJAMIN NOYES PT, DPT : WESTFIELD, IN

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General NPI Number Information
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    NPI Number           |    1902620271
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    Entity Type          |    Individual 
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    Provider Name        |    BRENNENJAMIN NOYES PT, DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/13/2024
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    Last Update Date     |    01/05/2026
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Provider Practice Location Address
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    Address Line         |    631 INTERSTATE 32 
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    City                 |    WESTFIELD
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    State                |    IN
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    Zip                  |    46074
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    Country              |    US
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    Telephone            |    317-399-1062
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    631 INTERSTATE 32 
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    City                 |    WESTFIELD
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    State                |    IN
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    Zip                  |    46074
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    Country              |    US
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    Telephone            |    
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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       |    05015815A
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    License Number State |    IN
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