Provider Demographics
NPI:1679851414
Name:BRAUN, KIM (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:BRAUN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NA
Other - Middle Name:
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2632 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4054
Mailing Address - Country:US
Mailing Address - Phone:303-777-4511
Mailing Address - Fax:
Practice Address - Street 1:1800 JULIAN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1622
Practice Address - Country:US
Practice Address - Phone:303-777-4511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11353225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist