Provider Demographics
NPI:1275821100
Name:CUMMINGS, BRENDON KYLE (DPT)
Entity Type:Individual
Prefix:DR
First Name:BRENDON
Middle Name:KYLE
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 GREEN LN
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007-5600
Mailing Address - Country:US
Mailing Address - Phone:215-826-0166
Mailing Address - Fax:215-826-0285
Practice Address - Street 1:100 GREEN LN
Practice Address - Street 2:SUITE 1
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-5600
Practice Address - Country:US
Practice Address - Phone:215-826-0166
Practice Address - Fax:215-826-0285
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021484225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist