MEDICARE: MR. DAVID CURTIS CANADAY

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
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1275793234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID CURTIS CANADAY

Provider Business Mailing Address
First Line	:	4960 FENTON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-2723
Country	:	US
Telephone Number	:	303-455-2961
Fax Number	:

Provider Business Practice Location Address
First Line	:	6060 E ILIFF AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-5721
Country	:	US
Telephone Number	:	303-759-4221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2008
Last Update Date	:	06/12/2008

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