Provider Demographics
NPI:1538462452
Name:BRAEGGER, JUSTIN S (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:S
Last Name:BRAEGGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23943 BROADMOOR PL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3158
Mailing Address - Country:US
Mailing Address - Phone:303-840-5090
Mailing Address - Fax:
Practice Address - Street 1:2532 SHERIDAN BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80214
Practice Address - Country:US
Practice Address - Phone:303-458-0294
Practice Address - Fax:303-477-0201
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60151330111N00000X
COCHR0006664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor