Provider Demographics
NPI:1568654051
Name:BRUNETTE, JAANA ANNELI (PT)
Entity Type:Individual
Prefix:
First Name:JAANA
Middle Name:ANNELI
Last Name:BRUNETTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10695 W 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-2700
Mailing Address - Country:US
Mailing Address - Phone:303-232-7100
Mailing Address - Fax:303-238-0621
Practice Address - Street 1:10695 W 17TH AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-2700
Practice Address - Country:US
Practice Address - Phone:303-232-7100
Practice Address - Fax:303-238-0621
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO56422251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics