Provider Demographics
NPI:1942472469
Name:BRUMBAUGH, BRENDA L (PT)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:L
Last Name:BRUMBAUGH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:BRENDA
Other - Middle Name:L
Other - Last Name:LOOMIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:2109 US HIGHWAY 522 S
Mailing Address - Street 2:
Mailing Address - City:MC VEYTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17051-9429
Mailing Address - Country:US
Mailing Address - Phone:814-542-8630
Mailing Address - Fax:814-542-2828
Practice Address - Street 1:2109 US HIGHWAY 522 S
Practice Address - Street 2:
Practice Address - City:MC VEYTOWN
Practice Address - State:PA
Practice Address - Zip Code:17051-9429
Practice Address - Country:US
Practice Address - Phone:814-542-8630
Practice Address - Fax:814-542-2828
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006678L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist