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NPI Code Detail

MEDICARE: DR. NICOLE LOSSE PT, DPT

MEDICARE: DR. NICOLE LOSSE PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPTL.0013954CO

General Provider Information

NPI Number : 1245771989
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE LOSSE PT, DPT
Provider Business Mailing Address
First Line : 901 N SANTA FE AVE
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-1738
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 N SANTA FE AVE
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-1738
Country : US
Telephone Number : 719-597-0822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2017
Last Update Date : 10/09/2020

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