Provider Demographics
NPI:1295944064
Name:BRENZIKOFER, CHAD STEVEN (CSCS, MT)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:STEVEN
Last Name:BRENZIKOFER
Suffix:
Gender:M
Credentials:CSCS, MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 W SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1630
Mailing Address - Country:US
Mailing Address - Phone:303-778-7246
Mailing Address - Fax:303-871-0830
Practice Address - Street 1:1550 S PEARL ST STE 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2645
Practice Address - Country:US
Practice Address - Phone:303-778-7246
Practice Address - Fax:303-871-0830
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor