Provider Demographics
NPI:1215903349
Name:BROOKS, BRONWYN E (RPT)
Entity type:Individual
Prefix:MS
First Name:BRONWYN
Middle Name:E
Last Name:BROOKS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:901 ENGLEWOOD PKWY
Mailing Address - Street 2:# 108
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2305
Mailing Address - Country:US
Mailing Address - Phone:303-761-3085
Mailing Address - Fax:303-761-4066
Practice Address - Street 1:901 ENGLEWOOD PKWY
Practice Address - Street 2:# 108
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2305
Practice Address - Country:US
Practice Address - Phone:303-761-3085
Practice Address - Fax:303-761-4066
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4489225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic