Provider Demographics
NPI:1518391903
Name:NOEHREN, BRIAN (PT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:NOEHREN
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 1:900S LIMESTONE
Mailing Address - Street 2:CHARLES WETHINGTON BUILDING ROOM 204D
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0581
Mailing Address - Country:US
Mailing Address - Phone:859-218-0581
Mailing Address - Fax:
Practice Address - Street 1:900S LIMESTONE
Practice Address - Street 2:CHARLES WETHINGTON BUILDING ROOM 204D
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0581
Practice Address - Country:US
Practice Address - Phone:859-218-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist