MEDICARE: BRIAN T. WESSEL MPT

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	2251X0800X	Orthopedic Physical Therapist	PT24676	CA

General Provider Information

NPI Number	:	1891887253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN T. WESSEL MPT

Provider Business Mailing Address
First Line	:	6880 S MCCARRAN BLVD
Second Line	:	STE 13
City	:	RENO
State	:	NV
Zip	:	89509-6129
Country	:	US
Telephone Number	:	775-399-4094
Fax Number	:	775-201-6613

Provider Business Practice Location Address
First Line	:	6880 S MCCARRAN BLVD
Second Line	:	STE 13
City	:	RENO
State	:	NV
Zip	:	89509-6129
Country	:	US
Telephone Number	:	775-399-4094
Fax Number	:	775-210-6613

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	03/11/2019

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