MEDICARE: DR. BRIAN MICHAEL INSELMAN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2354	NE

General Provider Information

NPI Number	:	1538147095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN MICHAEL INSELMAN DPT

Provider Business Mailing Address
First Line	:	4102 TWIN CREEK DR
Second Line	:	STE 108
City	:	BELLEVUE
State	:	NE
Zip	:	68123-4024
Country	:	US
Telephone Number	:	402-502-4678
Fax Number	:	402-933-9137

Provider Business Practice Location Address
First Line	:	4102 TWIN CREEK DR
Second Line	:	STE 108
City	:	BELLEVUE
State	:	NE
Zip	:	68123-4024
Country	:	US
Telephone Number	:	402-502-4678
Fax Number	:	402-933-9137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	10/30/2012

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