Provider Demographics
NPI:1588735294
Name:BREWSTER, ROBERT JEFFREY (PT OCS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JEFFREY
Last Name:BREWSTER
Suffix:
Gender:M
Credentials:PT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:40 INDUSTRY RD STE 3
Mailing Address - Street 2:
Mailing Address - City:MARSTONS MILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02648-1760
Mailing Address - Country:US
Mailing Address - Phone:508-420-0022
Mailing Address - Fax:508-420-0088
Practice Address - Street 1:40 INDUSTRY RD
Practice Address - Street 2:
Practice Address - City:MARSTONS MILLS
Practice Address - State:MA
Practice Address - Zip Code:02648-1760
Practice Address - Country:US
Practice Address - Phone:508-420-0022
Practice Address - Fax:508-420-0088
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10120225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist