MRS. Vicki Ellen Brungard, PTA

NPI #1114579075 in Williamsport, Pennsylvania

Provider Information

NPI Number: 1114579075
Entity Type: Individual
Name: MRS. Vicki Ellen Brungard, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jul 11, 2019
Last Updated: Jul 11, 2019

Practice Location

Address: 1705 WARREN AVE STE 102
City: Williamsport
State: Pennsylvania
ZIP Code: 17701
Phone: (570) 320-7470

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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