Provider Demographics
NPI:1699244277
Name:PIPER, BRETT (AT, ATC)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:PIPER
Suffix:
Gender:M
Credentials:AT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6937 HAWTHORN TRCE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5352
Mailing Address - Country:US
Mailing Address - Phone:419-366-0088
Mailing Address - Fax:
Practice Address - Street 1:33600 INWOOD DR
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-4132
Practice Address - Country:US
Practice Address - Phone:419-366-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0032082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer