Provider Demographics
NPI:1205392321
Name:HARVEY, BRIANNA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:SHINGLEHOUSE
Mailing Address - State:PA
Mailing Address - Zip Code:16748-0485
Mailing Address - Country:US
Mailing Address - Phone:814-203-3009
Mailing Address - Fax:
Practice Address - Street 1:2902 SOUTH RT. 44
Practice Address - Street 2:
Practice Address - City:SHINGLEHOUSE
Practice Address - State:PA
Practice Address - Zip Code:16748
Practice Address - Country:US
Practice Address - Phone:814-203-3009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007606225100000X
PAPT026418225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist