Provider Demographics
NPI:1205280781
Name:BARRETT, BRANDY E (PT)
Entity type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:E
Last Name:BARRETT
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 1:100 HIGH RISE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-3202
Mailing Address - Country:US
Mailing Address - Phone:502-966-4466
Mailing Address - Fax:502-964-3271
Practice Address - Street 1:100 HIGH RISE
Practice Address - Street 2:SUITE 110
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-3202
Practice Address - Country:US
Practice Address - Phone:502-966-4466
Practice Address - Fax:502-964-3271
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004895225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist