Individual
MR. BRYAN LORENZO WIDDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
22480 PEBBLE BROOK LN, PARKER, CO 80138-8390
(303) 550-3268
Mailing address
22480 PEBBLE BROOK LN, PARKER, CO 80138-8390
(303) 550-3268
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0003001
CO
Other
Enumeration date
09/02/2009
Last updated
02/01/2024
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