Provider Demographics
NPI:1740302140
Name:DELANO, BRANDON T (MSPT)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:T
Last Name:DELANO
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 JAMECO MILL RD
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8215
Mailing Address - Country:US
Mailing Address - Phone:207-396-5685
Mailing Address - Fax:
Practice Address - Street 1:2 DAVIS POINT LN
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-2620
Practice Address - Country:US
Practice Address - Phone:207-767-9773
Practice Address - Fax:207-541-9212
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT2417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEPT2417OtherPHYSICAL THERAPY LICENSE