Provider Demographics
NPI:1912680190
Name:BJORGUM, BROOKE DANAE (DPT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:DANAE
Last Name:BJORGUM
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OAKWOOD PARK PLZ STE 200
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1885
Mailing Address - Country:US
Mailing Address - Phone:720-788-7365
Mailing Address - Fax:720-294-0284
Practice Address - Street 1:502 E PIKES PEAK AVE STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3697
Practice Address - Country:US
Practice Address - Phone:719-473-2958
Practice Address - Fax:194-731-0047
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0019294225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist