Basic Information
| Provider Information | |||||||||
| NPI: | 1003352899 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FIT PHYSICAL TEHRAPY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6612 S WARD ST | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801274855 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034092133 | ||||||||
| FaxNumber: | 3034092233 | ||||||||
| Practice Location | |||||||||
| Address1: | 1555 DOVER ST | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802153105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034092133 | ||||||||
| FaxNumber: | 3034092233 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2017 | ||||||||
| LastUpdateDate: | 01/17/2017 | ||||||||
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| AuthorizedOfficialLastName: | COSTELLO | ||||||||
| AuthorizedOfficialFirstName: | PATTY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3034092133 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.