# MR. BRIAN ELMO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1215990551
- **Gender:** Man
- **Credential:** M.P.T., A.T.C., C.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 006539 | CT | Yes |

## Other

- **Enumeration date:** 04/08/2006
- **Last updated:** 06/13/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 7488045 | AETNA | CT |
| 01 | — | 9077328 | PHCS | CT |