MEDICARE: SOPHIE BROCKHAUS 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
1	225100000X	Physical Therapist	4815	NE

General Provider Information

NPI Number	:	1821985144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIE BROCKHAUS DPT

Provider Business Mailing Address
First Line	:	PO BOX 8
Second Line	:
City	:	PIERCE
State	:	NE
Zip	:	68767-0008
Country	:	US
Telephone Number	:	402-329-4050
Fax Number	:	402-329-4057

Provider Business Practice Location Address
First Line	:	105 E MAIN ST
Second Line	:
City	:	PIERCE
State	:	NE
Zip	:	68767-1343
Country	:	US
Telephone Number	:	402-329-4050
Fax Number	:	402-329-4057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2025
Last Update Date	:	06/19/2025

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Directions to “ SOPHIE BROCKHAUS DPT” Practice Location

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