Provider Demographics
NPI:1831076868
Name:BRUNER, KATHRYN ALAIN (PT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ALAIN
Last Name:BRUNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KIT
Other - Middle Name:
Other - Last Name:BRUNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:10211 S 45TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-1105
Mailing Address - Country:US
Mailing Address - Phone:206-605-5596
Mailing Address - Fax:
Practice Address - Street 1:4350 E RAY RD STE 101A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4707
Practice Address - Country:US
Practice Address - Phone:480-704-5954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist