Individual
BREANA LYNN KOFFLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
413 SUMMIT BLVD, SUITE 102, BROOMFIELD, CO 80021-8294
(303) 499-6565
(303) 499-8585
Mailing address
10650 YATES DR, WESTMINSTER, CO 80031-1984
(303) 912-4959
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7869
CO
225400000X
Rehabilitation Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7869
PT LISCENSE NUMBER
CO
Enumeration date
05/17/2007
Last updated
12/22/2010
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