Provider Demographics
NPI:1215308861
Name:KOEHLER, BRITTANY (ATC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:KOEHLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ATC
Mailing Address - Street 1:951 W PLUM ST
Mailing Address - Street 2:SUITE 141
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80523-4087
Mailing Address - Country:US
Mailing Address - Phone:520-241-0005
Mailing Address - Fax:
Practice Address - Street 1:3002 W. ELIZABETH 24F
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521
Practice Address - Country:US
Practice Address - Phone:520-241-0005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001192255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer