Individual
BEAU BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, CES
Contact information
Practice address
7232 S BLACKHAWK ST APT 4-103, ENGLEWOOD, CO 80112-4016
(719) 760-9953
Mailing address
7232 S BLACKHAWK ST UNIT 4-103, ENGLEWOOD, CO 80112-4016
(719) 760-9953
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.0002142
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
—
Enumeration date
07/21/2020
Last updated
07/21/2020
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