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General NPI Number Information
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NPI Number | 1770779951
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Entity Type | Individual
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Provider Name | KIMBERLY MICHELLE BRUHN PT
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Gender | Female
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 100 PARK RD
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City | NOCONA
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State | TX
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Zip | 76255-3616
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Country | US
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Telephone | 940-825-7246
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Fax | 940-825-3323
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Provider Business Mailing Address
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Address Line | 205 HILLCREST DR
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City | NOCONA
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State | TX
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Zip | 76255-3010
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Country | US
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Telephone | 940-825-5069
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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 | 1108082
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License Number State | TX
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