Provider Demographics
NPI:1568943017
Name:LANGHAM, BRETT ALAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:ALAN
Last Name:LANGHAM
Suffix:
Gender:M
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 1:8205 PRESIDENTS DR FL 2
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-8621
Mailing Address - Country:US
Mailing Address - Phone:717-839-2159
Mailing Address - Fax:717-565-1104
Practice Address - Street 1:5057 PINNACLE SQUARE
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35235
Practice Address - Country:US
Practice Address - Phone:205-655-9222
Practice Address - Fax:205-655-9233
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH9069225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist