Bradley David Bangs, PT
Individual provider Active NPI Physical Therapist · Aurora, NE
NPI 1639258668 · NPPES record last updated Aug 30, 2012
Key facts
- NPI
- 1639258668
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 58715342401 (UT)
- Practice address
- 1423 7TH St
Aurora, NE 68818-1141 - Phone
- (402) 694-8254
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 58715342401 | UT | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 58715342401 | UT | Yes |
Addresses
Primary practice location
1423 7TH St
Aurora, NE 68818-1141
Mailing address
1423 7TH St
Aurora, NE 68818-1141
Phone (402) 694-8254
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P6311 | Medicaid | UT |
Other providers in Aurora, NE
- Timothy L Arthur
- Aurora Advanced Chiropractic Center
- Aurora Public School
- Balanced Vision, LLC
- Kachine Marie Banahan
- Lorri Ann Brown
- Michelle Bullerman
- Kesean Rae Bundy
- Bergen Carraher
- Jessica Cervantes
All providers in Aurora, NE · Physical Therapist in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2012. 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.