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NPI Code Detail

MEDICARE: MICHAEL VAN PORTFLIET DPT

MEDICARE: MICHAEL VAN PORTFLIET 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 Therapist0013420CO

General Provider Information

NPI Number : 1871975169
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL VAN PORTFLIET DPT
Provider Business Mailing Address
First Line : 6840 S UNIVERSITY BLVD STE 400
Second Line :
City : CENTENNIAL
State : CO
Zip : 80122-1510
Country : US
Telephone Number : 303-771-5120
Fax Number :
Provider Business Practice Location Address
First Line : 6840 S UNIVERSITY BLVD STE 400
Second Line :
City : CENTENNIAL
State : CO
Zip : 80122-1510
Country : US
Telephone Number : 303-771-5120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2015
Last Update Date : 06/23/2015

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Directions to “ MICHAEL VAN PORTFLIET DPT” Practice Location

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