Basic Information
| Provider Information | |||||||||
| NPI: | 1770774358 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MYERS | ||||||||
| FirstName: | BRIDGET | ||||||||
| MiddleName: | MEANEY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PT, DPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MEANEY | ||||||||
| OtherFirstName: | BRIDGET | ||||||||
| OtherMiddleName: | A | ||||||||
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| OtherCredential: | DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 290 NICKEL ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BROOMFIELD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800202183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034609151 | ||||||||
| FaxNumber: | 3034607443 | ||||||||
| Practice Location | |||||||||
| Address1: | 290 NICKEL ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BROOMFIELD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800202183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034609151 | ||||||||
| FaxNumber: | 3034607443 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2007 | ||||||||
| LastUpdateDate: | 08/20/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 9702 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.