Individual
SCOTT BRONSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2812 STATE ROUTE 174, MARIETTA, NY 13110-3202
(347) 924-2720
Mailing address
2812 STATE ROUTE 174, MARIETTA, NY 13110-3202
(347) 924-2720
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P03396
NY
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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