Healthcare Provider Details

I. General information

NPI: 1295372183
Provider Name (Legal Business Name): BRANDON DENNY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 12/10/2019
Certification Date: 12/10/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7735 W LONG DR UNIT 12
LITTLETON CO
80123-1262
US

IV. Provider business mailing address

7735 W LONG DR UNIT 12
LITTLETON CO
80123-1262
US

V. Phone/Fax

Practice location:
  • Phone: 303-904-0331
  • Fax:
Mailing address:
  • Phone: 303-904-0331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0008116
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: