Provider Demographics
NPI:1801868427
Name:OAKES, BRIAN JAMES (ATC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:JAMES
Last Name:OAKES
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BARBER RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16917-9600
Mailing Address - Country:US
Mailing Address - Phone:570-659-5562
Mailing Address - Fax:
Practice Address - Street 1:DECKER GYMNASIUM STADIUM DRIVE
Practice Address - Street 2:MANSFIELD UNIVERSITY
Practice Address - City:MANSFIELD
Practice Address - State:PA
Practice Address - Zip Code:16917
Practice Address - Country:US
Practice Address - Phone:570-662-4635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0014484A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer