Provider Demographics
NPI:1518204155
Name:BRUHN, JEREMY JOEL (DPT)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:JOEL
Last Name:BRUHN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2698 N MARION ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-4457
Mailing Address - Country:US
Mailing Address - Phone:303-413-9903
Mailing Address - Fax:
Practice Address - Street 1:2861 W 120TH AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2987
Practice Address - Country:US
Practice Address - Phone:303-413-9903
Practice Address - Fax:303-413-9907
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT39732225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO335418YLBGMedicare UPIN