Bryan R Gerondale in Glendale - Sports Physician
Bryan R Gerondale - NPI 1598852147
Bryan R Gerondale is a Sports Physician in Glendale, Wisconsin. Bryan R Gerondale practices all healthcare services and medical treatments related to Sports Physician. The NPI Number for Bryan R Gerondale is 1598852147. The last update date is 2017-04-04.
Bryan R Gerondale's current location address is 5306 N Port Washington Rd, Glendale, Wisconsin. You can contact this provider via phone number 4143320859 and fax number 4143323991. The mailing address for Bryan R Gerondale is 5306 N Port Washington Rd, Glendale, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bryan R Gerondale |
|---|---|
| Address | 5306 N Port Washington Rd, Glendale, Wisconsin |
| Phone Number | 4143320859 |
| Fax Number | 4143323991 |
| Sole Proprietor | N |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1598852147 |
|---|---|
| Provider Enumeration Date | 2006-10-06 |
| Last Updated Date | 2017-04-04 |
Provider Mailing Address Detail
| Address | 5306 N Port Washington Rd |
|---|---|
| City | Glendale |
| State | Wisconsin (WI) |
| Post Code | 532174913 |
| Phone Number | 4143320859 |
| Fax Number | 4143323991 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Physician |
|---|---|
| Taxonomy | 111Ns0005X |
| Licence No | 1776-012 |
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Definition: A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 38776000 | WI | -- |
Post Comment/ Review Below
What is the Bryan R Gerondale's 1598852147?
The Bryan R Gerondale's NPI (National Provider Identifier) Number is 1598852147. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Bryan R Gerondale is geographically located?
The Bryan R Gerondale is physically situated at the following location: 5306 N Port Washington Rd, Glendale, WI, 532174913.
What is Bryan R Gerondale's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Bryan R Gerondale's specialized field of practice is Sports Physician, and the corresponding taxonomy code that categorizes this area of specialization is 111Ns0005X.
When did Bryan R Gerondale receive its 1598852147 assignment?
The Bryan R Gerondale was assigned its 1598852147 on 2006-10-06, which is the date when this unique identifier was issued to the organization.
When was the information related to Bryan R Gerondale most recently updated or refreshed?
The details pertaining to the Bryan R Gerondale, including its address, specialty, and other relevant information, were last updated or refreshed on 2017-04-04.
NPI Number: 1902809924
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