Individual
GRANT BRACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
340 EXEMPLA CIR STE 300, LAFAYETTE, CO 80026-3384
(303) 673-1390
(720) 627-6407
Mailing address
340 EXEMPLA CIR STE 300, LAFAYETTE, CO 80026-3384
(303) 673-1390
(720) 627-6407
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0006486
CO
Other
Enumeration date
04/23/2020
Last updated
04/20/2023
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