Provider Demographics
NPI:1811940406
Name:BRACH, PAUL (PT)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BRACH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 BOWER HILL RD
Mailing Address - Street 2:STE 203
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1145 BOWER HILL RD
Practice Address - Street 2:SUITE 203
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1342
Practice Address - Country:US
Practice Address - Phone:412-429-1980
Practice Address - Fax:412-429-1981
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007413L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist