Provider Demographics
NPI:1366125015
Name:WITHEREL, BRIANNA (PT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:WITHEREL
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 1:4325 RTE 51N
Mailing Address - Street 2:
Mailing Address - City:ROSTRAVER TWP
Mailing Address - State:PA
Mailing Address - Zip Code:15012-3535
Mailing Address - Country:US
Mailing Address - Phone:724-565-5806
Mailing Address - Fax:724-483-0290
Practice Address - Street 1:1033 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2123
Practice Address - Country:US
Practice Address - Phone:412-366-3880
Practice Address - Fax:412-366-7655
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031653225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist