Individual
MARTIN BREA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA ATC LAT
Contact information
Practice address
155 WILSON AVE, WASHINGTON, PA 15301-3336
(724) 223-3262
Mailing address
155 WILSON AVE, WASHINGTON, PA 15301-3336
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
RT000246A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
812335
CERTIFIED ATHLETIC TRAINER
PA
Enumeration date
12/20/2014
Last updated
12/20/2014
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