Basic Information
| Provider Information | |||||||||
| NPI: | 1639409709 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DENVER PHYSICAL THERAPY, P.C. | ||||||||
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| OtherOrganizationName: | PRO ACTIVE PT SOUTHLANDS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7310 S ALTON WAY | ||||||||
| Address2: | STE 6L | ||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801122334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037904495 | ||||||||
| FaxNumber: | 7204881988 | ||||||||
| Practice Location | |||||||||
| Address1: | 24300 E SMOKY HILL RD | ||||||||
| Address2: | #126 | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800161387 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4085700510 | ||||||||
| FaxNumber: | 4089454018 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2010 | ||||||||
| LastUpdateDate: | 02/04/2020 | ||||||||
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| AuthorizedOfficialLastName: | JACOB | ||||||||
| AuthorizedOfficialFirstName: | ERIKA | ||||||||
| AuthorizedOfficialMiddleName: | EDEN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3036280871 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.