Provider Demographics
NPI:1578130381
Name:CAMPBELL, BRIEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRIEN
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 S QUEBEC ST STE 107A
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2201
Mailing Address - Country:US
Mailing Address - Phone:303-689-2222
Mailing Address - Fax:
Practice Address - Street 1:5600 S QUEBEC ST STE 107A
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2201
Practice Address - Country:US
Practice Address - Phone:303-689-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4531225100000X
CO0019066225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist