Provider Demographics
NPI:1588064117
Name:BRAHMBHATT, UTSAV (PT, DPT)
Entity type:Individual
Prefix:
First Name:UTSAV
Middle Name:
Last Name:BRAHMBHATT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W MIDLAND TRL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-4004
Mailing Address - Country:US
Mailing Address - Phone:804-543-3438
Mailing Address - Fax:
Practice Address - Street 1:325 W MIDLAND TRL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-4004
Practice Address - Country:US
Practice Address - Phone:804-543-3438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037961225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist