Provider Demographics
NPI:1972805034
Name:BRANDENBURG, BARBARA BECK (DPT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:BECK
Last Name:BRANDENBURG
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 1:9600 TWO NOTCH RD
Mailing Address - Street 2:SUITE #26
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223
Mailing Address - Country:US
Mailing Address - Phone:803-736-5540
Mailing Address - Fax:803-699-0951
Practice Address - Street 1:9600 TWO NOTCH RD
Practice Address - Street 2:SUITE #26
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223
Practice Address - Country:US
Practice Address - Phone:803-736-5540
Practice Address - Fax:803-699-0951
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist