Provider Demographics
NPI:1215767256
Name:FLEITMAN, BRENNA
Entity type:Individual
Prefix:
First Name:BRENNA
Middle Name:
Last Name:FLEITMAN
Suffix:
Gender:F
Credentials:
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 271
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:TX
Mailing Address - Zip Code:76250-0271
Mailing Address - Country:US
Mailing Address - Phone:940-736-3953
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 271
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:TX
Practice Address - Zip Code:76250-0271
Practice Address - Country:US
Practice Address - Phone:940-736-3953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist