Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT28076 | CA |
N | 2251S0007X | Physical Therapist - Sports | PT28076 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT28076 | CA |
NPI | 1346326907 |
---|---|
Provider Name | Christopher Gulbrandson |
First Address | Rocklin, CA 95765-5886 |
Second Address | Rocklin, CA 95765-5874 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 03/04/2020 |