Brunel Bajon

Individual provider Active NPI Physical Therapy Assistant · Plymouth Meeting, PA

NPI 1962704247 · NPPES record last updated Nov 19, 2010

Key facts

NPI
1962704247
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
8272 (MA)
Practice address
2250 Hickory Rd
Plymouth Meeting, PA 19462-1047
Phone
(610) 834-1122
NPI assigned
Nov 19, 2010
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8272MAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 8272 MA Yes

Addresses

Primary practice location

2250 Hickory Rd
Plymouth Meeting, PA 19462-1047

Mailing address

2250 Hickory Rd
Plymouth Meeting, PA 19462-1047

Other providers in Plymouth Meeting, PA

All providers in Plymouth Meeting, PA · Physical Therapy Assistant in Pennsylvania

Sources for this page

Verify at the official NPI Registry.