Provider Demographics
NPI:1801174289
Name:WOSLAGER, BRETT JOHN (DPT)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:JOHN
Last Name:WOSLAGER
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 1:290 NICKEL ST
Mailing Address - Street 2:STE 200
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2183
Mailing Address - Country:US
Mailing Address - Phone:303-460-9151
Mailing Address - Fax:
Practice Address - Street 1:290 NICKEL ST
Practice Address - Street 2:STE 200
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2183
Practice Address - Country:US
Practice Address - Phone:303-460-9151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11348225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist