MEDICARE: BRIAN BREMMER 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	225100000X	Physical Therapist	40QA01604200	NJ
2	225100000X	Physical Therapist	PTL.0016830	CO

General Provider Information

NPI Number	:	1851786784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN BREMMER DPT

Provider Business Mailing Address
First Line	:	433 SUMMIT BLVD UNIT 104
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80021-8299
Country	:	US
Telephone Number	:	201-957-5250
Fax Number	:

Provider Business Practice Location Address
First Line	:	433 SUMMIT BLVD UNIT 104
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80021-8299
Country	:	US
Telephone Number	:	201-445-0900
Fax Number	:

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

Provider Enumeration Date	:	03/30/2015
Last Update Date	:	10/06/2020

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