Brockett, Bryan James

Brockett, Bryan James is an individual health care provider with primary practice located at 5546 S Fort Apache Rd Ste 200 , Las Vegas NV 89148-7692. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Brockett, Bryan James can be contacted via phone (702) 947-9994.

Contact Information

Primary practice address
5546 S Fort Apache Rd Ste 200 Las Vegas NV 89148-7692
Phone: (702) 947-9994
Fax: (702) 947-9998
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1590 Nevada

Profile Details

NPI number 1699767335
LBN Legal business name Brockett, Bryan James
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Apr 18th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699767335 NPPES
Nevada Other NV1590 BCBS
Nevada MEDICAID 100503507 BCBS

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