Provider Demographics
NPI:1457510943
Name:PITTMAN, BREE ANN (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:BREE
Middle Name:ANN
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 W 86TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2002
Mailing Address - Country:US
Mailing Address - Phone:317-415-5642
Mailing Address - Fax:317-415-5635
Practice Address - Street 1:1707 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2002
Practice Address - Country:US
Practice Address - Phone:317-415-5642
Practice Address - Fax:317-415-5635
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007163A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics