Provider Demographics
NPI:1225027196
Name:GARG, BRENDA K (CMT)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:K
Last Name:GARG
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:720 S COLORADO BLVD
Mailing Address - Street 2:SUITE 200-A, DEPT 914
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1912
Mailing Address - Country:US
Mailing Address - Phone:303-584-8000
Mailing Address - Fax:303-584-8141
Practice Address - Street 1:120 BRYANT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-2141
Practice Address - Country:US
Practice Address - Phone:303-937-6112
Practice Address - Fax:303-727-9215
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO066615OtherMEDICARE GROUP #