Healthcare Provider Details
I. General information
NPI: 1205037447
Provider Name (Legal Business Name): JAYME BRINDLE MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7200 S ALTON WAY STE B110
CENTENNIAL CO
80112-2263
US
IV. Provider business mailing address
1717 EAST ST
GOLDEN CO
80401-1946
US
V. Phone/Fax
- Phone: 720-489-0790
- Fax:
- Phone: 303-279-1285
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 8075 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: