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NPI Code Detail

MEDICARE: MS. BRYNN KUSIAK PT

MEDICARE: MS. BRYNN KUSIAK 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
1225100000XPhysical Therapist040-0002061VT

General Provider Information

NPI Number : 1992853030
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BRYNN KUSIAK PT
Provider Business Mailing Address
First Line : 115 WELLNESS DR
Second Line :
City : WILLISTON
State : VT
Zip : 05495-2088
Country : US
Telephone Number : 802-860-1358
Fax Number : 802-860-1093
Provider Business Practice Location Address
First Line : 115 WELLNESS DR
Second Line :
City : WILLISTON
State : VT
Zip : 05495-2088
Country : US
Telephone Number : 802-860-1358
Fax Number : 802-860-1093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 07/08/2007

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