Provider Demographics
NPI:1740355759
Name:LABELL, BRYAN AARON (DPT, CSCS)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:AARON
Last Name:LABELL
Suffix:
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PATTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:S HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982
Mailing Address - Country:US
Mailing Address - Phone:978-948-5511
Mailing Address - Fax:978-948-5515
Practice Address - Street 1:139 MAPLE ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2060
Practice Address - Country:US
Practice Address - Phone:978-777-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist