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General NPI Number Information
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NPI Number | 1417983586
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Entity Type | Individual
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Provider Name | ALEXANDER KARL BRENNER PT
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 851 IRELAND AVE
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City | FORT KNOX
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State | KY
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Zip | 40121
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Country | US
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Telephone | 502-624-5851
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Fax |
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Provider Business Mailing Address
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Address Line | 403 CHESTNUT ST
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-9434
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Country | US
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Telephone | 270-272-2682
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 04011
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License Number State | KY
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