Provider Demographics
NPI:1548360092
Name:POPPIE, BRADLEY ALLEN
Entity type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:ALLEN
Last Name:POPPIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 ASHWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80126-7581
Mailing Address - Country:US
Mailing Address - Phone:303-470-1275
Mailing Address - Fax:720-344-5787
Practice Address - Street 1:3600 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2103
Practice Address - Country:US
Practice Address - Phone:303-984-5531
Practice Address - Fax:303-984-5563
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7428225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist