Provider Demographics
NPI:1629511910
Name:MCFARLAND, BRYAN (CTRS)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:MCFARLAND
Suffix:
Gender:M
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 LORDS LN
Mailing Address - Street 2:
Mailing Address - City:DEEP RIVER
Mailing Address - State:CT
Mailing Address - Zip Code:06417-2041
Mailing Address - Country:US
Mailing Address - Phone:860-575-6757
Mailing Address - Fax:
Practice Address - Street 1:459 WALLINGFORD RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:CT
Practice Address - Zip Code:06422-1125
Practice Address - Country:US
Practice Address - Phone:860-349-2043
Practice Address - Fax:860-349-2147
Is Sole Proprietor?:No
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT59410225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist