Provider Demographics
NPI:1023053840
Name:GAMBALE, BRENDA B (MED, ATC)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:B
Last Name:GAMBALE
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 SADDLEBROOK LN
Mailing Address - Street 2:UNIT #599
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-7174
Mailing Address - Country:US
Mailing Address - Phone:859-341-5600
Mailing Address - Fax:859-341-5669
Practice Address - Street 1:830 THOMAS MORE PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5102
Practice Address - Country:US
Practice Address - Phone:859-341-5600
Practice Address - Fax:859-341-5669
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer