Provider Demographics
NPI:1376676809
Name:BRAND, TORY H (PT)
Entity type:Individual
Prefix:MRS
First Name:TORY
Middle Name:H
Last Name:BRAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TORY
Other - Middle Name:HAZE
Other - Last Name:ROWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6812 N STERLING AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-4049
Mailing Address - Country:US
Mailing Address - Phone:813-431-5344
Mailing Address - Fax:
Practice Address - Street 1:7171 N DALE MABRY HWY
Practice Address - Street 2:SUITE 503
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2630
Practice Address - Country:US
Practice Address - Phone:813-930-8454
Practice Address - Fax:813-930-9554
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19711225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist