Healthcare Provider Details

I. General information

NPI: 1982143616
Provider Name (Legal Business Name): BRANDON BRASHIER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 PEAK ONE DR
FRISCO CO
80443
US

IV. Provider business mailing address

340 PEAK ONE DR ST 120
FRISCO CO
80443
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-3300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number0014021
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: