MEDICARE: MR. TODD M BRUTTO PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT-005489-L	PA

General Provider Information

NPI Number	:	1346299120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TODD M BRUTTO PT

Provider Business Mailing Address
First Line	:	1820 FOX RUN TER
Second Line	:
City	:	WARRINGTON
State	:	PA
Zip	:	18976-2809
Country	:	US
Telephone Number	:	215-343-5019
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 FLORAL VALE BLVD
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-5522
Country	:	US
Telephone Number	:	215-860-4270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	05/06/2015

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