Provider Demographics
NPI:1710320502
Name:BREUNIG, NICHOLAS MATTHEW (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:MATTHEW
Last Name:BREUNIG
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:1760 COUNTY ROAD J
Mailing Address - Street 2:
Mailing Address - City:WAHOO
Mailing Address - State:NE
Mailing Address - Zip Code:68066-4152
Mailing Address - Country:US
Mailing Address - Phone:402-443-4191
Mailing Address - Fax:402-443-1445
Practice Address - Street 1:1760 COUNTY ROAD J
Practice Address - Street 2:
Practice Address - City:WAHOO
Practice Address - State:NE
Practice Address - Zip Code:68066-4152
Practice Address - Country:US
Practice Address - Phone:402-443-4191
Practice Address - Fax:402-443-1445
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE31542251G0304X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics