Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 32695 | CO |
NPI | 1033174446 |
---|---|
Provider Name | Gretchen Brunworth |
First Address | Aurora, CO 80012-4529 |
Second Address | Aurora, CO 80011-6750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 07/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01326958 | (05) | CO |
F68071 | (02) | CO |