Provider Demographics
NPI:1851389860
Name:PHELAN, BRETT BERNARD (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:BERNARD
Last Name:PHELAN
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Gender:M
Credentials:ATC, LAT
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Mailing Address - Street 1:148 MASON TER
Mailing Address - Street 2:APT 2
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2772
Mailing Address - Country:US
Mailing Address - Phone:215-901-8733
Mailing Address - Fax:
Practice Address - Street 1:285 BABCOCK ST
Practice Address - Street 2:BOSTON UNIVERSITY SPORTS MEDICINE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1003
Practice Address - Country:US
Practice Address - Phone:617-358-4289
Practice Address - Fax:617-353-7579
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA016332255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer