Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PTL.0012898 | CO |
Y | 2251G0304X | Physical Therapist - Geriatrics | PTL.0012898 | CO |
NPI | 1255728309 |
---|---|
Provider Name | Max Bringe |
First Address | Fort Collins, CO 80524-3914 |
Second Address | Fort Collins, CO 80524-3914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2015 |
Last Update Date | 07/05/2019 |