Basic Information
Provider Information
NPI: 1003145228
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOYT
FirstName: BRYAN
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7730 ALTHEA AVE
Address2:  
City: HARRISBURG
State: PA
PostalCode: 171123803
CountryCode: US
TelephoneNumber: 7175450488
FaxNumber:  
Practice Location
Address1: 626 S. MARKET STREET
Address2:  
City: ELIZABETHTOWN
State: PA
PostalCode: 17022
CountryCode: US
TelephoneNumber: 7173617414
FaxNumber: 7173617443
Other Information
ProviderEnumerationDate: 12/17/2009
LastUpdateDate: 12/17/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT-010896LPAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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