Provider Demographics
NPI:1649895210
Name:BRAMMER, MASON ALAN (T-OTA)
Entity type:Individual
Prefix:
First Name:MASON
Middle Name:ALAN
Last Name:BRAMMER
Suffix:
Gender:M
Credentials:T-OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 TIMBERVALE TRL
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6945
Mailing Address - Country:US
Mailing Address - Phone:714-365-4842
Mailing Address - Fax:
Practice Address - Street 1:13825 W 85TH DR STE 200
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-1328
Practice Address - Country:US
Practice Address - Phone:720-524-4659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
COT-OTA.0000016OtherDEPARTMENT OF REGULATORY AGENCIES