MEDICARE: DR. CHRISTY ETHRIDGE BRIMMER PT, DPT, NCS

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	PT007782	GA

General Provider Information

NPI Number	:	1699287102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTY ETHRIDGE BRIMMER PT, DPT, NCS

Provider Business Mailing Address
First Line	:	301 MAIN ST SW
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3777
Country	:	US
Telephone Number	:	678-971-1843
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 MAIN ST SW
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3777
Country	:	US
Telephone Number	:	678-971-1843
Fax Number	:

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

Provider Enumeration Date	:	10/25/2017
Last Update Date	:	10/25/2017

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