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NPI Code Detail

MEDICARE: MRS. BRANDI ANNE ZETROUER PT

MEDICARE: MRS. BRANDI ANNE ZETROUER 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
12251P0200XPediatric Physical Therapist6297SC

General Provider Information

NPI Number : 1457660490
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRANDI ANNE ZETROUER PT
Provider Business Mailing Address
First Line : 139 PAMPAS DR
Second Line :
City : POOLER
State : GA
Zip : 31322-4031
Country : US
Telephone Number : 912-844-3227
Fax Number :
Provider Business Practice Location Address
First Line : 3090 PREMIERE PKWY STE 400
Second Line :
City : DULUTH
State : GA
Zip : 30097-8915
Country : US
Telephone Number : 877-407-3422
Fax Number : 877-407-4329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2010
Last Update Date : 03/27/2025

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