=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275391641
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANY M OWEN PTA, BSKIN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2024
-----------------------------------------------------
Last Update Date | 03/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6900 E 47TH AVENUE DR STE 150
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80216-3401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-920-1200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10621 RACINE ST
-----------------------------------------------------
City | COMMERCE CITY
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80022-6635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-284-6025
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | PTA.0013406
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------