Provider Demographics
NPI:1306300256
Name:FINCH, BRYAN CHRISTOPHER (PT)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:CHRISTOPHER
Last Name:FINCH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2063 ALAMEDA AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4208
Mailing Address - Country:US
Mailing Address - Phone:510-798-0053
Mailing Address - Fax:
Practice Address - Street 1:4501 BROADWAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4615
Practice Address - Country:US
Practice Address - Phone:510-752-6295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24640225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist