Healthcare Provider Details

I. General information

NPI: 1750210837
Provider Name (Legal Business Name): NICHOLAS BRUNSMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9596 COLERAIN AVE
CINCINNATI OH
45251-2004
US

IV. Provider business mailing address

6372 SPRINGMYER DR
CINCINNATI OH
45248-2133
US

V. Phone/Fax

Practice location:
  • Phone: 513-909-3460
  • Fax:
Mailing address:
  • Phone: 513-807-1602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT022423
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: