Provider Demographics
NPI:1699287102
Name:BRIMMER, CHRISTY ETHRIDGE (PT, DPT, NCS)
Entity type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:ETHRIDGE
Last Name:BRIMMER
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MAIN ST SW
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3777
Mailing Address - Country:US
Mailing Address - Phone:678-971-1843
Mailing Address - Fax:
Practice Address - Street 1:301 MAIN ST SW
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3777
Practice Address - Country:US
Practice Address - Phone:678-971-1843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007782225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist