Healthcare Provider Details

I. General information

NPI: 1518270362
Provider Name (Legal Business Name): SHANNON D BROWNING MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 HUMBOLDT ST ST 101
DENVER CO
80218-1130
US

IV. Provider business mailing address

1909 SHEELY DR
FORT COLLINS CO
80526-1939
US

V. Phone/Fax

Practice location:
  • Phone: 303-850-7717
  • Fax:
Mailing address:
  • Phone: 303-938-1775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number6680
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: