Provider Demographics
NPI:1568744308
Name:ROBERTS, BRENT A (PT)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:A
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-218-4260
Mailing Address - Fax:303-218-4249
Practice Address - Street 1:14000 E ARAPAHOE RD
Practice Address - Street 2:#160
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4043
Practice Address - Country:US
Practice Address - Phone:303-218-4260
Practice Address - Fax:303-218-4249
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2012-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO114052251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic