Provider Demographics
NPI:1760817944
Name:BREWER, KRISTEN (DPT)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:BREWER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 W MOORHEAD CIR
Mailing Address - Street 2:2A
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6163
Mailing Address - Country:US
Mailing Address - Phone:301-606-8913
Mailing Address - Fax:
Practice Address - Street 1:850 W MOORHEAD CIR
Practice Address - Street 2:2A
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6163
Practice Address - Country:US
Practice Address - Phone:301-606-8913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0012330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist