Timothy Joseph Brassard, MS PT

Individual provider Active NPI Physical Therapist · Bristol, RI

NPI 1235468554 · NPPES record last updated Dec 15, 2009

Key facts

NPI
1235468554
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT01740 (RI)
Practice address
175 Wood St
Bristol, RI 02809-3117
Phone
(401) 253-2863
NPI assigned
Dec 15, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT01740RIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT01740 RI Yes

Addresses

Primary practice location

175 Wood St
Bristol, RI 02809-3117

Mailing address

175 Wood St
Bristol, RI 02809-3117
Phone (401) 253-2863

Other providers in Bristol, RI

All providers in Bristol, RI · Physical Therapist in Rhode Island

Sources for this page

Verify at the official NPI Registry.