Provider Demographics
NPI:1295169506
Name:SHEEHAN, BRANDON KYLE (DPT)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:KYLE
Last Name:SHEEHAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6980 MESA RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-1563
Mailing Address - Country:US
Mailing Address - Phone:719-391-0044
Mailing Address - Fax:
Practice Address - Street 1:6980 MESA RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-1563
Practice Address - Country:US
Practice Address - Phone:719-391-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305213336225100000X
COMSPTL.000031225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist