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NPI Code Detail

MEDICARE: MR. BRANDON STAPANOWICH DPT

MEDICARE:  MR. BRANDON  STAPANOWICH  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPTL.0010750CO

General Provider Information

NPI Number : 1275904377
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRANDON STAPANOWICH DPT
Provider Business Mailing Address
First Line : 155 PANTHER WAY
Second Line :
City : WOODLAND PARK
State : CO
Zip : 80863-3165
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 155 PANTHER WAY
Second Line :
City : WOODLAND PARK
State : CO
Zip : 80863-3165
Country : US
Telephone Number : 719-357-3307
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2015
Last Update Date : 01/18/2024

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Directions to “ MR. BRANDON STAPANOWICH DPT” Practice Location

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