Provider Demographics
NPI:1811373152
Name:BRISSON, JEAN (ND)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:BRISSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10090 GARRISON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3894
Mailing Address - Country:US
Mailing Address - Phone:303-502-7570
Mailing Address - Fax:
Practice Address - Street 1:10090 GARRISON ST STE 101
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-3894
Practice Address - Country:US
Practice Address - Phone:303-502-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000103175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath