Provider Demographics
NPI:1497270730
Name:MARUCA, BREANNE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:BREANNE
Middle Name:
Last Name:MARUCA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:BRANNE
Other - Middle Name:
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1104 W HIGH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-1707
Mailing Address - Country:US
Mailing Address - Phone:814-478-2087
Mailing Address - Fax:
Practice Address - Street 1:1104 W HIGH ST STE 2
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-1707
Practice Address - Country:US
Practice Address - Phone:814-478-2087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026203225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist