Provider Demographics
NPI:1518911189
Name:BRUMMEL, DAVID F (M ED PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:F
Last Name:BRUMMEL
Suffix:
Gender:M
Credentials:M ED PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:816-226-4011
Mailing Address - Fax:816-524-6115
Practice Address - Street 1:540 E YOUNG AVE
Practice Address - Street 2:SUITE E
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-1231
Practice Address - Country:US
Practice Address - Phone:660-262-4795
Practice Address - Fax:660-747-0347
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01604225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA4370031OtherMEDICARE PTAN
19980080OtherBCBS KC
MO19980030OtherBCBSKC
MO19980040OtherBCBSKC
MOMA254002Medicare PIN
MOR21B381Medicare PIN
MOMA2104003Medicare PIN
MOR26B381Medicare PIN