Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Brandon Lee Mack, DPT

Individual provider Physical Therapist · NPI 1134188832

Dr. Brandon Lee Mack, DPT is a Physical Therapist in Private Practice in Kirksville, Missouri. Qualified in 2004, 22 years ago. Accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
22
Licensed in
MO
In the registry since
2006
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

Junction S Hwy 63 & 6E Outpatient Physical Therapy
Kirksville, MO 63501
Phone: (660) 785-1834
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2004021474 (MO)

Record details

NPI number1134188832
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedMarch 21, 2006
Last updated in NPPESJuly 13, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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