Search › Pennsylvania › 2255A2300X
Brent Theriault, ATC, LAT
NPI 1598332090 · on the registry since 2021
Practice
- Address
- 3149 Chester Ave
Bethlehem, PA 18020 - Phone
- (609) 350-5998
- Organisation at this address
- Colonial Intermediate Unit 20
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Also registered as
- 2255A2300X
- Licence states on file
- PA, NJ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-06-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania