MEDICARE: BRENDA SUE TOSCHIK 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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	650025363	OTHER	OR	RAILROAD MEDICARE PALMETTO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	840161001	OTHER	OR	BLUE CROSS
2	1124066170	OTHER		GROUP NPI

General Provider Information

NPI Number	:	1346317120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA SUE TOSCHIK PT

Provider Business Mailing Address
First Line	:	2846 EBERLEIN AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-4402
Country	:	US
Telephone Number	:	541-850-8909
Fax Number	:	541-882-4005

Provider Business Practice Location Address
First Line	:	2846 EBERLEIN AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-4402
Country	:	US
Telephone Number	:	541-850-8909
Fax Number	:	541-882-4005

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

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	10/06/2011

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Directions to “ BRENDA SUE TOSCHIK PT” Practice Location

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