Stephanie Bruggeman, PTA
Individual provider Active NPI Physical Therapy Assistant · Bellbrook, OH
NPI 1417548355 · NPPES record last updated Feb 2, 2021
Key facts
- NPI
- 1417548355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 011330 (OH)
- Practice address
- 3151 Bugle Bluff Dr
Bellbrook, OH 45305-8854 - Phone
- (937) 974-8801
- NPI assigned
- Feb 2, 2021
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011330 | OH | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 011330 | OH | Yes |
| Physical Therapy Assistant | 225200000X |
Addresses
Primary practice location
3151 Bugle Bluff Dr
Bellbrook, OH 45305-8854
Mailing address
3151 Bugle Bluff Dr
Bellbrook, OH 45305-8854
Other providers in Bellbrook, OH
- Kimberli Suzanne Blaschak
- Eric Bletzinger
- Craig Dean Boreman
- Sharae Branch
- Bruce A Brown
- Tiffany Lynne Buller
- Jennifer Lynn Burns
- Kaitlin Bushroe
- Julie Lyn Buzzard
- Yissell Carpentino
All providers in Bellbrook, OH · Physical Therapy Assistant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.