Provider Demographics
NPI:1255329975
Name:FINK, BRIAN D (PT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:FINK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S ARCH AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4202
Mailing Address - Country:US
Mailing Address - Phone:330-821-0201
Mailing Address - Fax:330-821-1924
Practice Address - Street 1:1401 S ARCH AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4202
Practice Address - Country:US
Practice Address - Phone:330-821-0201
Practice Address - Fax:330-821-1924
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-06632225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000385561OtherANTHEM
OHQ039397OtherHOMETOWN