Provider Demographics
NPI:1821519281
Name:BRANDT, ZANE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ZANE
Middle Name:
Last Name:BRANDT
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 1:211 N CLINTON ST STE 2N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-1283
Mailing Address - Country:US
Mailing Address - Phone:877-709-1090
Mailing Address - Fax:866-221-3400
Practice Address - Street 1:9909 MIRA MESA BLVD STE 260
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1064
Practice Address - Country:US
Practice Address - Phone:877-709-1090
Practice Address - Fax:858-384-1542
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist