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Individual

TIMOTHY BRANDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
70 PENNINGTON DR, #9, BLUFFTON, SC 29910-6055
(843) 815-3131
Mailing address
38 HIDDEN LAKES CIR, BLUFFTON, SC 29910-8010
(843) 757-8038

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1549
LICENSE #
SC
Enumeration date
08/30/2006
Last updated
07/08/2007
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