Individual
BRIAN MICHAEL GENTRY
Active
Individual
BRIAN MICHAEL GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10092
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079R4
BCBS
NC
01
—
6400040
UNITED HEALTHCARE
—
01
—
7187712
AETNA
—
05
—
7211783
—
NC
05
—
8300041K
—
NC
01
—
E4463
MEDCOST
—
Enumeration date
12/22/2006
Last updated
07/09/2007
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