Provider Demographics
NPI:1285075796
Name:TINCHER, BRANDON (LPTA)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:TINCHER
Suffix:
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 1:2501 MOUNTAIN VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:ST. ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177
Mailing Address - Country:US
Mailing Address - Phone:304-237-9638
Mailing Address - Fax:
Practice Address - Street 1:2501 MOUNTAIN VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:ST. ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177
Practice Address - Country:US
Practice Address - Phone:304-237-9638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23042225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant