Provider Demographics
NPI:1912761370
Name:BIERMANN, BRAYDEN JUSTIN
Entity type:Individual
Prefix:
First Name:BRAYDEN
Middle Name:JUSTIN
Last Name:BIERMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 HIGHWAY 57 STE B
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50665-1075
Mailing Address - Country:US
Mailing Address - Phone:319-346-9783
Mailing Address - Fax:319-346-9785
Practice Address - Street 1:80 AMHERST BLVD STE 300
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:IA
Practice Address - Zip Code:50658-9712
Practice Address - Country:US
Practice Address - Phone:641-435-4476
Practice Address - Fax:641-435-4491
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist