Provider Demographics
NPI:1275651689
Name:BRUSH, CARRIE F (PT)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:F
Last Name:BRUSH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 LIEBCHEN CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-9067
Mailing Address - Country:US
Mailing Address - Phone:513-310-9585
Mailing Address - Fax:
Practice Address - Street 1:1695 LIEBCHEN CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-9067
Practice Address - Country:US
Practice Address - Phone:513-310-9585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006440A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist