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NPI Code Detail

MEDICARE: ERIN PIETRO PTA

MEDICARE: ERIN PIETRO PTA
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
1225200000XPhysical Therapy Assistant0014083CO

General Provider Information

NPI Number : 1710403647
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN PIETRO PTA
Provider Business Mailing Address
First Line : 4830 VAN GORDON ST
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-2116
Country : US
Telephone Number : 720-379-8802
Fax Number :
Provider Business Practice Location Address
First Line : 7481 KNOX PL
Second Line :
City : WESTMINSTER
State : CO
Zip : 80030-4818
Country : US
Telephone Number : 303-427-7101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2017
Last Update Date : 08/22/2017

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