Provider Demographics
NPI:1346767274
Name:WILLBRANT, JOEL (PT)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:WILLBRANT
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 1:506 PLAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-2745
Mailing Address - Country:US
Mailing Address - Phone:781-319-0024
Mailing Address - Fax:
Practice Address - Street 1:506 PLAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2745
Practice Address - Country:US
Practice Address - Phone:781-319-0024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist