Provider Demographics
NPI:1225461635
Name:AHRENS, BRANDON ALEXANDER
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:ALEXANDER
Last Name:AHRENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N 70TH TER APT 521
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-3153
Mailing Address - Country:US
Mailing Address - Phone:785-672-0427
Mailing Address - Fax:
Practice Address - Street 1:301 N 70TH TER APT 521
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-3153
Practice Address - Country:US
Practice Address - Phone:785-672-0427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant