Provider Demographics
NPI:1760049571
Name:MARLER, BRETT
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:MARLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7061 CHARMINGDALE DR S
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36618-4515
Mailing Address - Country:US
Mailing Address - Phone:251-776-8701
Mailing Address - Fax:
Practice Address - Street 1:7061 CHARMINGDALE DR S
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36618-4515
Practice Address - Country:US
Practice Address - Phone:251-776-8701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTA8336225200000X
COPTA0014560225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant