Provider Demographics
NPI:1710928635
Name:BRUMFIELD, JOHN PATRICK (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:BRUMFIELD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10742 OAKLINE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3317
Mailing Address - Country:US
Mailing Address - Phone:225-683-1111
Mailing Address - Fax:225-683-1177
Practice Address - Street 1:9609 PLANK RD
Practice Address - Street 2:SUITE P
Practice Address - City:CLINTON
Practice Address - State:LA
Practice Address - Zip Code:70722-3702
Practice Address - Country:US
Practice Address - Phone:225-683-1111
Practice Address - Fax:225-683-1177
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA02247225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist