Provider Demographics
NPI:1407563992
Name:BRIMEYER, BROOKE
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:BRIMEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 230TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND MOUND
Mailing Address - State:IA
Mailing Address - Zip Code:52751-9611
Mailing Address - Country:US
Mailing Address - Phone:563-451-4721
Mailing Address - Fax:
Practice Address - Street 1:402 2ND AVE
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:IA
Practice Address - Zip Code:52216-9754
Practice Address - Country:US
Practice Address - Phone:563-452-3262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA112907225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist