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NPI Code Detail

MEDICARE: BRENDAN BRAUSE PT

MEDICARE: BRENDAN BRAUSE PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2021006164MO

General Provider Information

NPI Number : 1306430905
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDAN BRAUSE PT
Provider Business Mailing Address
First Line : 647 SPIRIT AIRPARK WEST DR STE 101
Second Line :
City : CHESTERFIELD
State : MO
Zip : 63005-1032
Country : US
Telephone Number : 636-223-5700
Fax Number :
Provider Business Practice Location Address
First Line : 1348 BASS PRO DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-2461
Country : US
Telephone Number : 636-757-5075
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2021
Last Update Date : 06/20/2024

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Directions to “ BRENDAN BRAUSE PT” Practice Location

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