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NPI Code Detail

MEDICARE: JOSHUA RALPH BREMSETH DPT

MEDICARE: JOSHUA RALPH BREMSETH DPT
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 Therapist12259TN

General Provider Information

NPI Number : 1821653734
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA RALPH BREMSETH DPT
Provider Business Mailing Address
First Line : 2225 FROSTLAND LN
Second Line :
City : KNOXVILLE
State : TN
Zip : 37931-3922
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3100 OLYMPUS BLVD STE 500
Second Line :
City : COPPELL
State : TX
Zip : 75019-5473
Country : US
Telephone Number : 866-221-5405
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2019
Last Update Date : 05/06/2019

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