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General NPI Number Information
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NPI Number | 1184903262
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Entity Type | Individual
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Provider Name | BRANDON JAMES WEHENKEL PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 08/08/2011
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Last Update Date | 08/08/2011
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Provider Practice Location Address
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Address Line | 1314 3RD AVE
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City | NEBRASKA CITY
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State | NE
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Zip | 68410-1930
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Country | US
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Telephone | 402-873-8918
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Fax |
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Provider Business Mailing Address
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Address Line | 1716 P ST
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City | AUBURN
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State | NE
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Zip | 68305-1740
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Country | US
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Telephone | 402-274-7500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2993
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License Number State | NE
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