Provider Demographics
NPI:1154805299
Name:BRAKEFIELD, SETH C (DPT)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:C
Last Name:BRAKEFIELD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 SECREST ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-2848
Mailing Address - Country:US
Mailing Address - Phone:570-417-1622
Mailing Address - Fax:
Practice Address - Street 1:11325 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-2601
Practice Address - Country:US
Practice Address - Phone:303-457-2022
Practice Address - Fax:303-457-2320
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026987225100000X
COPTL.0015877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist