Individual
BRANDON KISHBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
109 W 9TH ST, BERWICK, PA 18603-3024
(570) 759-0389
Mailing address
722 MOUNT PLEASANT RD, BLOOMSBURG, PA 17815-7246
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013514
PA
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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