Most Relevant Information
Provider Data
| NPI Number: | 1003306697 |
| Provider Name: | BRANDON DALE PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT003963 |
Most Important Dates
| Enumeration Date: | 05/18/2018 |
| Last Updated: | 12/08/2022 |
Provider Practice Location
116 APPLEWOOD DR
ONA
WV
255459581
Practice Location Phone/Fax
| Phone: | 2769706076 |
| Fax: |
Provider Mailing Location
2523 YATES CROSSING RD
MILTON
WV
255418509
Provider Mailing Phone/Fax
| Phone: | 2769706076 |
| Fax: |