Provider Demographics
NPI:1124624275
Name:BREX, DAVID W I (LPTA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:W
Last Name:BREX
Suffix:I
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BLANDING RD
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-1201
Mailing Address - Country:US
Mailing Address - Phone:774-991-1109
Mailing Address - Fax:
Practice Address - Street 1:7 BLANDING RD
Practice Address - Street 2:
Practice Address - City:REHOBOTH
Practice Address - State:MA
Practice Address - Zip Code:02769-1201
Practice Address - Country:US
Practice Address - Phone:774-991-1109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPTA00392225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant