Provider Demographics
NPI:1902399272
Name:BEHRENS, BRUCE E
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:E
Last Name:BEHRENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 STANGE RD
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3914
Mailing Address - Country:US
Mailing Address - Phone:515-956-4050
Mailing Address - Fax:
Practice Address - Street 1:3815 STANGE RD
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010
Practice Address - Country:US
Practice Address - Phone:515-956-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist