Healthcare Provider Details

I. General information

NPI: 1669850533
Provider Name (Legal Business Name): MANN METHOD PHYSICAL THERAPY AND FITNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2015
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13825 W. 85TH DRIVE SUITE 200
ARVADA CO
80005-5950
US

IV. Provider business mailing address

20074 W 94TH LN
ARVADA CO
80007-7718
US

V. Phone/Fax

Practice location:
  • Phone: 720-524-4659
  • Fax: 303-256-0572
Mailing address:
  • Phone: 303-709-6381
  • Fax: 303-256-0572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number0011874
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier83455388
Identifier TypeMEDICAID
Identifier StateCO
Identifier Issuer
# 2
Identifier501438
Identifier TypeOTHER
Identifier StateCO
Identifier IssuerMEDICARE PTAN

VIII. Authorized Official

Name: SARAH R.E. MANN
Title or Position: MANAGER, PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 303-709-6381