Provider Demographics
NPI:1578502761
Name:BRADEN, ROBIN D (PT)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:D
Last Name:BRADEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 BRECKENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-6085
Mailing Address - Country:US
Mailing Address - Phone:303-465-2523
Mailing Address - Fax:303-464-9911
Practice Address - Street 1:571 BRECKENRIDGE DR
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-6085
Practice Address - Country:US
Practice Address - Phone:303-465-2523
Practice Address - Fax:303-464-9911
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36132251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO513228Medicare ID - Type Unspecified