Provider Demographics
NPI:1225633316
Name:FARRAR, BRIANNA LYN (PT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LYN
Last Name:FARRAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:L
Other - Last Name:DOWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1 MEDICAL PARK
Mailing Address - Street 2:BUSINESS OFFICE - NTTC - CREDENTIALING
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6379
Mailing Address - Country:US
Mailing Address - Phone:304-243-3124
Mailing Address - Fax:304-243-1131
Practice Address - Street 1:3000 GUERNSEY ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:OH
Practice Address - Zip Code:43906-1540
Practice Address - Country:US
Practice Address - Phone:740-676-4623
Practice Address - Fax:740-671-6333
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT014930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist