Individual
BRANDON M KUDASIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
991 ROUTE 19N SUITE E, WATERFORD PHYSICAL THERAPY INC., WATERFORD, PA 16441-9739
(814) 796-3400
(814) 796-8533
Mailing address
991 ROUTE 19N SUITE E, WATERFORD PHYSICAL THERAPY INC., WATERFORD, PA 16441-9739
(814) 796-3400
(814) 796-8533
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT025206
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT025206
LICENSE
PA
Enumeration date
06/29/2016
Last updated
06/29/2016
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