Provider Demographics
NPI:1982055968
Name:PITMAN, BROOKE (PTA)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:PITMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4156 QUIVAS ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1845
Mailing Address - Country:US
Mailing Address - Phone:720-273-8204
Mailing Address - Fax:
Practice Address - Street 1:3401 QUEBEC ST STE 3100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-2325
Practice Address - Country:US
Practice Address - Phone:303-333-3493
Practice Address - Fax:303-388-8990
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO.0013662225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant