Provider Demographics
NPI:1821794405
Name:SPOCHART, BRANDI LYNN (PT)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:LYNN
Last Name:SPOCHART
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4915 ELEANOR DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-2723
Mailing Address - Country:US
Mailing Address - Phone:301-606-8940
Mailing Address - Fax:
Practice Address - Street 1:10521 PATUXENT RIDGE WAY
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-5719
Practice Address - Country:US
Practice Address - Phone:410-353-7589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20215225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist