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NPI Code Detail

MEDICARE: BRANDY LANCASTER

MEDICARE: BRANDY LANCASTER
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
1225200000XPhysical Therapy Assistant0013545CO

General Provider Information

NPI Number : 1396136032
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY LANCASTER
Provider Business Mailing Address
First Line : 25117 SW PARKWAY AVE
Second Line : STE D
City : WILSONVILLE
State : OR
Zip : 97070-9697
Country : US
Telephone Number : 888-757-3422
Fax Number :
Provider Business Practice Location Address
First Line : 2445 E CACHE LA POUDRE ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-4812
Country : US
Telephone Number : 719-471-8700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2015
Last Update Date : 02/17/2015

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Directions to “ BRANDY LANCASTER ” Practice Location

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