| Provider / Organization | NPI | Date Certified |
|---|---|---|
| BRIAN RICHARD CARLSON | 1255986097 | 2020-11-25 |
Brian Richard Carlson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1255986097. Registration indicates Brian Richard Carlson is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapist) (Physical Therapist, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Brian Richard Carlson |
| Practice Office Address | 5005 N. PIEDRAS ST. EL PASO, TX US |
| Practice Office Telephone | 6143718434 |
| Mailing Address | 2913 ROCKY RIDGE DR EL PASO, TX 799042420 US |
| Business Telephone | 6143718434 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 225100000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist Physical Therapist Speech/Occupational/Physical Therapy/Chiropractor Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | PT018930
OH |