1558315044 NPI number — DENVER PHYSICAL THERAPY, P.C.

Table of content: (NPI 1558315044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558315044 NPI number — DENVER PHYSICAL THERAPY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENVER PHYSICAL THERAPY, P.C.
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:
6
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:
1558315044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/31/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7310 S ALTON WAY
Provider Second Line Business Mailing Address:
STE 6L
Provider Business Mailing Address City Name:
CENTENNIAL
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-2334
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-790-4495
Provider Business Mailing Address Fax Number:
720-488-1988

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 CASTLETON RD
Provider Second Line Business Practice Location Address:
#100
Provider Business Practice Location Address City Name:
CASTLE ROCK
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80109-7552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-688-3914
Provider Business Practice Location Address Fax Number:
303-688-4499
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PACE
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
213-804-1712

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DEN0503 . This is a "ANTHEM BLUE CROSS/SHIELD" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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