Provider Demographics
NPI:1508688813
Name:KEENE, BRIAN (BS, LMT, CPT, CAFS)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:KEENE
Suffix:
Gender:M
Credentials:BS, LMT, CPT, CAFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 SOUTH SYRACUSE WAY
Mailing Address - Street 2:APT L303
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231
Mailing Address - Country:US
Mailing Address - Phone:720-673-2915
Mailing Address - Fax:
Practice Address - Street 1:7120 E ORCHARD RD
Practice Address - Street 2:STE 110
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:303-771-3329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0021273225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty