Basic Information
| Provider Information | |||||||||
| NPI: | 1124694419 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SPEER | ||||||||
| FirstName: | HOLDEN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 378 POTOMAC WAY APT D106 | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800118581 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3194009220 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 QUEBEC ST # 215 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802307144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033410369 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2021 | ||||||||
| LastUpdateDate: | 08/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 0017626 | CO | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | 225100000X | PTL.0017626 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.