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General NPI Number Information
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NPI Number | 1518204155
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Entity Type | Individual
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Provider Name | JEREMY JOEL BRUHN DPT
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Gender | Male
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 01/20/2017
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Provider Practice Location Address
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Address Line | 2861 W 120TH AVE SUITE 120
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City | WESTMINSTER
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State | CO
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Zip | 80234-2987
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Country | US
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Telephone | 303-413-9903
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Fax | 303-413-9907
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Provider Business Mailing Address
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Address Line | 2698 N MARION ST
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City | DENVER
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State | CO
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Zip | 80205-4457
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Country | US
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Telephone | 303-413-9903
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT39732
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License Number State | CA
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