Individual
MATTHEW P BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
10128 W BROAD ST, FORUM BUILDING III, SUITE K, GLEN ALLEN, VA 23060-6761
(804) 217-9210
(804) 217-9213
Mailing address
771 PILOT HOUSE DR, NEWPORT NEWS, VA 23606-1990
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11681
NC
225100000X
Physical Therapist
Primary
2305206387
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497981161
—
VA
01
—
192953
BCBS (PHYSICAL THERAPY)
VA
01
—
9223520
AETNA
VA
01
—
P00826481
RAILROAD MEDICARE
VA
Enumeration date
06/08/2009
Last updated
01/16/2011
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