Provider Demographics
NPI:1841970472
Name:GUTWEIN, BRANDT EUGENE (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRANDT
Middle Name:EUGENE
Last Name:GUTWEIN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5976 HARNEY DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-4202
Mailing Address - Country:US
Mailing Address - Phone:573-289-0264
Mailing Address - Fax:
Practice Address - Street 1:5731 SILVERSTONE TER STE 120
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3594
Practice Address - Country:US
Practice Address - Phone:719-598-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019172225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist