Provider Demographics
NPI:1225551567
Name:BRENKMANN, JOSHUA RICHARD (DPT)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:RICHARD
Last Name:BRENKMANN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 S 2000 W STE 1
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-9691
Mailing Address - Country:US
Mailing Address - Phone:801-896-9200
Mailing Address - Fax:801-896-1550
Practice Address - Street 1:736 S 2000 W STE 1
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-9691
Practice Address - Country:US
Practice Address - Phone:801-896-9200
Practice Address - Fax:801-896-1550
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9069084-48102255A2300X
UT9069084-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer