MEDICARE: DR. SHALE A BREITE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	273Y00000X	Rehabilitation Hospital Unit	0011686	CO

General Provider Information

NPI Number	:	1255764288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHALE A BREITE DPT

Provider Business Mailing Address
First Line	:	1540 GRANT ST
Second Line	:	APT 20
City	:	DENVER
State	:	CO
Zip	:	80203-1820
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 HIGH ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1213
Country	:	US
Telephone Number	:	303-331-5264
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2013
Last Update Date	:	08/13/2013

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Directions to “ DR. SHALE A BREITE DPT” Practice Location

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