Provider Demographics
NPI:1942636691
Name:BROHAMMER, BETH FAY (DPT)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:FAY
Last Name:BROHAMMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 SWEETLAND ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-8032
Mailing Address - Country:US
Mailing Address - Phone:805-746-6616
Mailing Address - Fax:
Practice Address - Street 1:1701 SOLAR DR STE 155
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-0139
Practice Address - Country:US
Practice Address - Phone:805-604-4644
Practice Address - Fax:805-604-4434
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT406082251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic