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Individual

JOE BRACKETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8988 BERMUDA RUN CIR, HIGHLANDS RANCH, CO 80130-3307
(720) 401-1379
Mailing address
8988 BERMUDA RUN CIR, HIGHLANDS RANCH, CO 80130-3307

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
293877
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
293877
MEDICARE
Enumeration date
07/19/2012
Last updated
07/19/2012
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