Provider Demographics
NPI:1902192446
Name:BRIGLIA, JOSEPH REID (DPT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:REID
Last Name:BRIGLIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 SUMMIT LAKE SHORE RD NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-9437
Mailing Address - Country:US
Mailing Address - Phone:609-707-7955
Mailing Address - Fax:
Practice Address - Street 1:1625 SUMMIT LAKE SHORE RD NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-9437
Practice Address - Country:US
Practice Address - Phone:609-707-7955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT26382225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist