Provider Demographics
NPI:1528100450
Name:HUGHES/BROGAN PHYSICAL THERAPY
Entity type:Organization
Organization Name:HUGHES/BROGAN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BROGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, ATC
Authorized Official - Phone:559-299-2244
Mailing Address - Street 1:145 SHAW AVE.
Mailing Address - Street 2:SUITE A.
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612
Mailing Address - Country:US
Mailing Address - Phone:559-299-2244
Mailing Address - Fax:559-299-2487
Practice Address - Street 1:145 SHAW AVE SUITE A
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-3841
Practice Address - Country:US
Practice Address - Phone:559-299-2244
Practice Address - Fax:559-299-2487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty