Provider Demographics
NPI:1710315627
Name:BRANSKE, JOSEPH (COTA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:BRANSKE
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 W COLORADO AVE # 169
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-2088
Mailing Address - Country:US
Mailing Address - Phone:719-761-9352
Mailing Address - Fax:
Practice Address - Street 1:3107 W COLORADO AVE # 169
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-2088
Practice Address - Country:US
Practice Address - Phone:719-761-9352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAA331249224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant