Andrew Braun, LAT, CSCS, CES
Individual provider Active NPI Rehabilitation Practitioner · Appleton, WI
NPI 1013396472 · NPPES record last updated May 19, 2015
Key facts
- NPI
- 1013396472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Rehabilitation Practitioner 225400000X
- License
- 1145-39 (WI)
- Practice address
- 101 W Edison Ave
Suite 110
Appleton, WI 54915-1367 - Phone
- (920) 209-1662
- NPI assigned
- May 19, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1145-39 | WI | MD | Rehabilitation Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Movement Studio | Past | Accepting new patients | |
| Advanced Movement Studio, LLC | Rehabilitation Practitioner | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | 1145-39 | WI | Yes |
Addresses
Primary practice location
101 W Edison Ave
Suite 110
Appleton, WI 54915-1367
Mailing address
101 W Edison Ave
Suite 110
Appleton, WI 54915-1367
Phone (920) 209-1662
Other providers in Appleton, WI
- Nicole A Brady
- Chintan Brahmbhatt
- Donna Mae Brantmeier
- Stephanie I. Braski
- Carolyn Brault
- Lauren Rae Braun
- Breath of Life Chiropractic Wellness Center
- Nancy Ann Breger
- Emily Breister
- Kristen Ann Brenner
All providers in Appleton, WI · Rehabilitation Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.