1124103155 NPI number — FELDHAKE PHYSICAL THERAPY, LTD.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124103155 NPI number — FELDHAKE PHYSICAL THERAPY, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FELDHAKE PHYSICAL THERAPY, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124103155
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7340 S ALTON WAY STE 11-D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTENNIAL
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-2323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-493-1181
Provider Business Mailing Address Fax Number:
720-493-1191

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1550 S PEARL ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80210-2645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-778-7246
Provider Business Practice Location Address Fax Number:
303-871-0830
Provider Enumeration Date:
10/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FELDHAKE
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
720-493-1181

Provider Taxonomy Codes

  • Taxonomy code: 2251X0800X , with the licence number:  7451 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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