Healthcare Provider Details

I. General information

NPI: 1225551567
Provider Name (Legal Business Name): JOSHUA RICHARD BRENKMANN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5171 S COTTONWOOD ST STE 900
MURRAY UT
84107-5704
US

IV. Provider business mailing address

PO BOX 25537
SALT LAKE CITY UT
84125-0537
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-2050
  • Fax:
Mailing address:
  • Phone: 801-507-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number9069084-4810
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9069084-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: