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NPI Code Detail

MEDICARE: MS. SHANNON MICHELE BROOKS MSPT

MEDICARE: MS. SHANNON MICHELE BROOKS MSPT
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 Therapist6355CO

General Provider Information

NPI Number : 1881841062
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHANNON MICHELE BROOKS MSPT
Provider Business Mailing Address
First Line : 2509 AKRON CT
Second Line :
City : DENVER
State : CO
Zip : 80238-2761
Country : US
Telephone Number : 303-883-0654
Fax Number :
Provider Business Practice Location Address
First Line : 2509 AKRON CT
Second Line :
City : DENVER
State : CO
Zip : 80238-2761
Country : US
Telephone Number : 303-883-0654
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2008
Last Update Date : 08/19/2008

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