Provider Demographics
NPI:1699922823
Name:WHITLEY, BRODIE LYNN (DPT)
Entity type:Individual
Prefix:
First Name:BRODIE
Middle Name:LYNN
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 PENN AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3208
Mailing Address - Country:US
Mailing Address - Phone:412-442-2343
Mailing Address - Fax:412-325-2538
Practice Address - Street 1:501 PENN AVE FL 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3208
Practice Address - Country:US
Practice Address - Phone:412-442-2343
Practice Address - Fax:412-325-2538
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019430225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist