Provider Demographics
NPI:1386660637
Name:BRINKERHOFF, GAIL TYLER (MSPT)
Entity type:Individual
Prefix:MR
First Name:GAIL
Middle Name:TYLER
Last Name:BRINKERHOFF
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 W 1325 N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-7792
Mailing Address - Country:US
Mailing Address - Phone:435-586-0064
Mailing Address - Fax:435-867-1243
Practice Address - Street 1:166 W 1325 N
Practice Address - Street 2:SUITE 100
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-7792
Practice Address - Country:US
Practice Address - Phone:435-586-0064
Practice Address - Fax:435-867-1243
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT590-3988225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
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UT2012098OtherFIRST HEALTH
UT650019316OtherRAILROAD MEDICARE
UT107008975102OtherSELECT HEALTH
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UT638620OtherDMBA
UT95310148202001OtherBCBS TRADITIONAL
UTPRA03877OtherMOLINA
UT870656237TB1OtherEDUCATORS MUTUAL
UT95310149204001OtherBCBS PPO