Provider Demographics
NPI:1154846913
Name:ENGELBRECHT, JOSHUA (MS, ATC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:ENGELBRECHT
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11633 MAPLE GLEN CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4253
Mailing Address - Country:US
Mailing Address - Phone:314-882-2853
Mailing Address - Fax:
Practice Address - Street 1:1 DENT DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-2005
Practice Address - Country:US
Practice Address - Phone:570-577-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-13
Last Update Date:2017-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer