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General NPI Number Information
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NPI Number | 1982587754
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Entity Type | Individual
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Provider Name | BROOKLYN CUNNINGHAM
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Gender | Female
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1325 S COLORADO BLVD STE 312
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City | DENVER
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State | CO
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Zip | 80222-3335
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Country | US
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Telephone | 720-479-8952
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Fax |
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Provider Business Mailing Address
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Address Line | 5856 N TOULON DR
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City | COEUR D ALENE
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State | ID
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Zip | 83815-8469
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Country | US
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Telephone | 208-277-8989
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PTL.0020635
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License Number State | CO
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