Individual
MR. ERIC DALE BRUMMEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
115 E GOODWIN ST, SUITE E1, PRESCOTT, AZ 86303-3926
(928) 445-5639
(928) 442-0031
Mailing address
PO BOX 13159, PRESCOTT, AZ 86304-3159
(928) 445-5639
(928) 442-0031
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3833
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
554239
—
AZ
01
—
AZ0463420
BCBS
AZ
Enumeration date
07/17/2006
Last updated
11/19/2008
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