Healthcare Provider Details

I. General information

NPI: 1285491928
Provider Name (Legal Business Name): BRENNA COLLEEN ROHNKOHL DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 MIDDLE TPKE W
MANCHESTER CT
06040-3834
US

IV. Provider business mailing address

2100 STONE CROFT ST
LAS VEGAS NV
89134-2541
US

V. Phone/Fax

Practice location:
  • Phone: 860-533-0356
  • Fax:
Mailing address:
  • Phone: 702-573-7004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL88726
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-8971
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT7342
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15516
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: