Provider Demographics
NPI:1255728309
Name:BRINGE, MAX (PT, DPT)
Entity type:Individual
Prefix:
First Name:MAX
Middle Name:
Last Name:BRINGE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S LEMAY AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3914
Mailing Address - Country:US
Mailing Address - Phone:970-224-7025
Mailing Address - Fax:970-224-7036
Practice Address - Street 1:1000 S LEMAY AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3914
Practice Address - Country:US
Practice Address - Phone:970-224-7025
Practice Address - Fax:970-224-7036
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.00128982251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty