Provider Demographics
NPI:1477920031
Name:DEWITT, BRIANNA ROSE (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:BRIANNA
Middle Name:ROSE
Last Name:DEWITT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-211 PALI MOMI ST STE 402
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4318
Mailing Address - Country:US
Mailing Address - Phone:808-450-9250
Mailing Address - Fax:800-573-1644
Practice Address - Street 1:98-211 PALI MOMI ST STE 402
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4318
Practice Address - Country:US
Practice Address - Phone:808-450-9250
Practice Address - Fax:800-573-1644
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-4046225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist