Provider Demographics
NPI:1821687658
Name:DUBOIS, BRANDON D (DPT)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:D
Last Name:DUBOIS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2 COMPUTER DR W
Mailing Address - Street 2:STE 200
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1622
Mailing Address - Country:US
Mailing Address - Phone:518-489-2524
Mailing Address - Fax:518-489-3167
Practice Address - Street 1:2 COMPUTER DR W
Practice Address - Street 2:STE 200
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1622
Practice Address - Country:US
Practice Address - Phone:518-489-2524
Practice Address - Fax:518-489-3167
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2022-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY043123225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist