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General NPI Number Information
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NPI Number | 1962421123
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Entity Type | Individual
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Provider Name | LAURIE BETH BRENNER MSPT
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 670 LINWOOD AVE STE 2
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City | WHITINSVILLE
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State | MA
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Zip | 01588-2068
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Country | US
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Telephone | 508-234-7544
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Fax | 508-234-8002
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Provider Business Mailing Address
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Address Line | 670 LINWOOD AVE STE 2
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City | WHITINSVILLE
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State | MA
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Zip | 01588-2068
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Country | US
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Telephone | 508-791-8740
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Fax | 508-752-3716
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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 | PT1307
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 16784
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License Number State | MA
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