Provider Demographics
NPI:1881390938
Name:BRANZEL PHYSICAL THERAPY
Entity type:Organization
Organization Name:BRANZEL PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRANZEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:707-363-7348
Mailing Address - Street 1:1975 FALLEN LEAF CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3559
Mailing Address - Country:US
Mailing Address - Phone:707-363-7348
Mailing Address - Fax:
Practice Address - Street 1:1495 RIDGEVIEW DR STE 120
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-6315
Practice Address - Country:US
Practice Address - Phone:775-323-5458
Practice Address - Fax:775-323-5239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy