Provider Demographics
NPI:1710456793
Name:BREWER, BRILEY
Entity Type:Individual
Prefix:
First Name:BRILEY
Middle Name:
Last Name:BREWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 N SIERRA ST UNIT 815
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-1372
Mailing Address - Country:US
Mailing Address - Phone:360-421-9505
Mailing Address - Fax:
Practice Address - Street 1:255 N SIERRA ST UNIT 815
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-1372
Practice Address - Country:US
Practice Address - Phone:360-421-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner