Provider Demographics
NPI:1912158460
Name:ROHN, BRANDI MICHELLE (PTA)
Entity type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:MICHELLE
Last Name:ROHN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 CANADA GOOSE CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-8172
Mailing Address - Country:US
Mailing Address - Phone:916-685-6906
Mailing Address - Fax:
Practice Address - Street 1:9280 W STOCKTON BLVD
Practice Address - Street 2:SUITE 116
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-8073
Practice Address - Country:US
Practice Address - Phone:916-683-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTA8801225200000X
IL160008182225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant