Provider Demographics
NPI:1285865428
Name:GIMLER, BRIAN J (PT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:GIMLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29743 42ND RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:KS
Mailing Address - Zip Code:67023-9313
Mailing Address - Country:US
Mailing Address - Phone:316-706-6731
Mailing Address - Fax:
Practice Address - Street 1:901 LAKEPOINT DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-2423
Practice Address - Country:US
Practice Address - Phone:316-775-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2013-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist