Provider Demographics
NPI:1558810291
Name:MATHEWS, BRIANNA (DPT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-9540
Mailing Address - Country:US
Mailing Address - Phone:484-526-5040
Mailing Address - Fax:
Practice Address - Street 1:5848 OLD BETHLEHEM PIKE STE 102
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-9341
Practice Address - Country:US
Practice Address - Phone:484-526-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist