Provider Demographics
NPI:1154956654
Name:CHEEHAN, BRIANNE (DPT)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:CHEEHAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:NY
Mailing Address - Zip Code:14506-0725
Mailing Address - Country:US
Mailing Address - Phone:585-582-6085
Mailing Address - Fax:
Practice Address - Street 1:58 N MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-1076
Practice Address - Country:US
Practice Address - Phone:585-582-0034
Practice Address - Fax:585-582-0026
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045749225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist